Assessment of insulin resistance in lean women with polycystic ovary syndrome.

Abstract:

OBJECTIVE:To develop and validate a specific simple measure of insulin sensitivity using oral glucose tolerance test (OGTT) values for lean polycystic ovary syndrome (PCOS) women. DESIGN:Retrospective study. SETTING:Gynecologic Outpatient Clinic of University Hospital, affiliated with Unit of Gynecologic Endocrinology. PATIENT(S):Totals of 201 lean and 198 overweight/obese (ov-ob) nondiabetic PCOS patients were retrospectively selected. INTERVENTION(S):None. MAIN OUTCOME MEASURE(S):All patients underwent OGTT, euglycemic-hyperinsulinemic clamp, and androgenic and biochemical assays. The predictive performance of each insulin resistance (IR) index was analyzed with the use of receiver operating characteristic (ROC) curves. RESULT(S):Higher correlation coefficients with clamp studies were obtained with the Belfiore Area (RS=0.579) and the homeostasis-model assessment (HOMA)-M120 (RS=-0.576) in lean PCOS patients and with the Sib (RS=0.697) in ov-ob PCOS patients. The best predictive index of IR in lean PCOS was a HOMA-M120 value of ≥12.8 or more (area under the ROC curve [AUC] 92.4%). In the ov-ob PCOS population, the best predictive performance was obtained by a Sib of ≤10.2 or less (AUC 85.7%). CONCLUSION(S):IR should be assessed in all PCOS women, both lean and ov-ob subjects. The HOMA-M120 resulted as a very simple tool, validated specifically for the lean PCOS woman whose cardiometabolic impairment is more frequently misunderstood.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Morciano A,Romani F,Sagnella F,Scarinci E,Palla C,Moro F,Tropea A,Policola C,Della Casa S,Guido M,Lanzone A,Apa R

doi

10.1016/j.fertnstert.2014.04.004

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

250-256.e3

issue

1

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(14)00315-X

journal_volume

102

pub_type

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