How Much Insulin Resistance in Polycystic Ovary Syndrome? Comparison of HOMA-IR and Insulin Resistance (Belfiore) Index Models

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2019 May 22

PMID 31110526

Citations 21

Authors

Krzysztof C Lewandowski

Elzbieta Skowronska-Jozwiak

Katarzyna Lukasiak

Katarzyna Galuszko

Aleksandra Dukowicz

Magdalena Cedro

Andrzej Lewinski

Affiliations

Soon will be listed here.

Abstract

Introduction: Polycystic ovary syndrome (PCOS), the commonest endocrinopathy of women in reproductive age, is often accompanied by insulin resistance (IR), hirsutism and/or fertility problems. The aim of the study was to assess the prevalence of IR in women diagnosed with PCOS.

Material And Methods: The study involved 137 women diagnosed with PCOS, according to the Rotterdam consensus criteria (2003). Insulin resistance was assessed according to the HOMA-IR method and insulin resistance (Belfiore) index (IRI) derived from glucose and insulin during the oral glucose tolerance test.

Results: There was a significant ( < 0.0001) but relatively moderate correlation between IRI and HOMA-IR ( = 0.5 and = 0.57 for a linear and non-linear model, respectively). Insulin resistance was more prevalent according to IRI (49.6%) than according to HOMA-IR (22.6% and 15.8% for 3.46 and 3.8 cut-off points, respectively, < 0.01). The majority of patients with high HOMA-IR also had high IRI (e.g. 86%, for HOMA > 3.8), but the majority of patients with raised IRI would not be diagnosed as insulin resistant according to HOMA (61.7% and 73.5%, for HOMA-IR and HOMA-IR, respectively).

Conclusions: The insulin resistance (Belfiore) index indicates more cases of insulin resistance than HOMA-IR in women with PCOS. Therefore, detection of insulin resistance among women with PCOS is highly method-dependent with more severe cases being detected with HOMA-IR than with IRI.

Citing Articles

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References

Poretsky L, Cataldo N, Rosenwaks Z, Giudice L . The insulin-related ovarian regulatory system in health and disease. Endocr Rev. 1999; 20(4):535-82. DOI: 10.1210/edrv.20.4.0374. View

Matsuda M, DeFronzo R . Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999; 22(9):1462-70. DOI: 10.2337/diacare.22.9.1462. View

Katz A, Nambi S, Mather K, Baron A, Follmann D, Sullivan G . Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000; 85(7):2402-10. DOI: 10.1210/jcem.85.7.6661. View

Kanauchi M, Tsujimoto N, Hashimoto T . Validation of simple indices to assess insulin sensitivity based on the oral glucose tolerance test in the Japanese population. Diabetes Res Clin Pract. 2002; 55(3):229-35. DOI: 10.1016/s0168-8227(01)00313-8. View

Wijeyaratne C, Balen A, Barth J, Belchetz P . Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference?. Clin Endocrinol (Oxf). 2002; 57(3):343-50. DOI: 10.1046/j.1365-2265.2002.01603.x. View

. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2003; 19(1):41-7. DOI: 10.1093/humrep/deh098. View

Azziz R, Woods K, Reyna R, Key T, Knochenhauer E, Yildiz B . The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004; 89(6):2745-9. DOI: 10.1210/jc.2003-032046. View

DeUgarte C, Bartolucci A, Azziz R . Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005; 83(5):1454-60. DOI: 10.1016/j.fertnstert.2004.11.070. View

Szurkowska M, Szafraniec K, Gilis-Januszewska A, Szybinski Z, Huszno B . [Insulin resistance indices in population-based study and their predictive value in defining metabolic syndrome]. Przegl Epidemiol. 2006; 59(3):743-51. View

10.

Radikova Z, Koska J, Huckova M, Ksinantova L, Imrich R, Vigas M . Insulin sensitivity indices: a proposal of cut-off points for simple identification of insulin-resistant subjects. Exp Clin Endocrinol Diabetes. 2006; 114(5):249-56. DOI: 10.1055/s-2006-924233. View

11.

Hoffman R . Indices of insulin action calculated from fasting glucose and insulin reflect hepatic, not peripheral, insulin sensitivity in African-American and Caucasian adolescents. Pediatr Diabetes. 2008; 9(3 Pt 2):57-61. DOI: 10.1111/j.1399-5448.2007.00350.x. View

12.

Hucking K, Watanabe R, Stefanovski D, Bergman R . OGTT-derived measures of insulin sensitivity are confounded by factors other than insulin sensitivity itself. Obesity (Silver Spring). 2008; 16(8):1938-45. PMC: 3417105. DOI: 10.1038/oby.2008.336. View

13.

Prelevic G, Wurzburger M, Nesic J . Inhibitory effect of sandostatin on secretion of luteinising hormone and ovarian steroids in polycystic ovary syndrome. Lancet. 1990; 336(8720):900-3. DOI: 10.1016/0140-6736(90)92270-r. View

14.

Muniyappa R, Irving B, Unni U, Briggs W, Nair K, Quon M . Limited predictive ability of surrogate indices of insulin sensitivity/resistance in Asian-Indian men. Am J Physiol Endocrinol Metab. 2010; 299(6):E1106-12. PMC: 3006259. DOI: 10.1152/ajpendo.00454.2010. View

15.

Lewandowski K, Cajdler-Luba A, Bienkiewicz M, Lewinski A . Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria. Neuro Endocrinol Lett. 2012; 32(6):847-56. View

16.

Studen K, Jensterle Sever M, Pfeifer M . Cardiovascular risk and subclinical cardiovascular disease in polycystic ovary syndrome. Front Horm Res. 2013; 40:64-82. DOI: 10.1159/000341838. View

17.

Welt C, Carmina E . Clinical review: Lifecycle of polycystic ovary syndrome (PCOS): from in utero to menopause. J Clin Endocrinol Metab. 2013; 98(12):4629-38. PMC: 3849665. DOI: 10.1210/jc.2013-2375. View

18.

Gayoso-Diz P, Otero-Gonzalez A, Rodriguez-Alvarez M, Gude F, Garcia F, de Francisco A . Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013; 13:47. PMC: 4016563. DOI: 10.1186/1472-6823-13-47. View

19.

Legro R, Arslanian S, Ehrmann D, Hoeger K, Murad M, Pasquali R . Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013; 98(12):4565-92. PMC: 5399492. DOI: 10.1210/jc.2013-2350. View

20.

Martinez-Larrad M, Anchuelo A, Prado N, Ibarra Rueda J, Gabriel R, Serrano-Rios M . Profile of individuals who are metabolically healthy obese using different definition criteria. A population-based analysis in the Spanish population. PLoS One. 2014; 9(9):e106641. PMC: 4157807. DOI: 10.1371/journal.pone.0106641. View