Toru Takeuchi1, Osamu Tsutsumi, Yuji Taketani. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. takeuchi-dis@h.u-tokyo.ac.jp
Abstract
OBJECTIVES: To investigate the insulin response to glucose loading and to determine which method is best in order to evaluate insulin resistance in women with polycystic ovary syndrome (PCOS). METHODS: In order to eliminate the influence of obesity on the variables, all subjects were non-obese. Standard oral glucose tolerance tests were performed in 23 normal women and 21 patients with PCOS. Insulin resistance was evaluated by the homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment for beta-cell function (HOMA-%B), the quantitative insulin-sensitivity check index (QUICKI) and area under the curve for glucose (AUC(glucose)) and insulin (AUC(insulin)). RESULTS: The mean values of HOMA-IR, AUC(insulin) and AUC(glucose) in the PCOS group were significantly higher than in the BMI-matched normal control group (p < 0.05, p < 0.01 and p < 0.01, respectively). There were significant positive correlations between AUC(insulin) and AUC(glucose) and androgens or luteinizing hormone in all subjects (p < 0.001). However, HOMA-IR and fasting insulin were significantly correlated only with total testosterone (p < 0.05). AUC(insulin) and AUC(glucose) values were elevated in more than 50% of PCOS patients with normal values of HOMA indices. CONCLUSION: In the PCOS group, the abnormal response of insulin to glucose loading was suggested. AUC(insulin) may be a better index than others to evaluate insulin resistance in non-obese PCOS patients.
OBJECTIVES: To investigate the insulin response to glucose loading and to determine which method is best in order to evaluate insulin resistance in women with polycystic ovary syndrome (PCOS). METHODS: In order to eliminate the influence of obesity on the variables, all subjects were non-obese. Standard oral glucose tolerance tests were performed in 23 normal women and 21 patients with PCOS. Insulin resistance was evaluated by the homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment for beta-cell function (HOMA-%B), the quantitative insulin-sensitivity check index (QUICKI) and area under the curve for glucose (AUC(glucose)) and insulin (AUC(insulin)). RESULTS: The mean values of HOMA-IR, AUC(insulin) and AUC(glucose) in the PCOS group were significantly higher than in the BMI-matched normal control group (p < 0.05, p < 0.01 and p < 0.01, respectively). There were significant positive correlations between AUC(insulin) and AUC(glucose) and androgens or luteinizing hormone in all subjects (p < 0.001). However, HOMA-IR and fasting insulin were significantly correlated only with total testosterone (p < 0.05). AUC(insulin) and AUC(glucose) values were elevated in more than 50% of PCOSpatients with normal values of HOMA indices. CONCLUSION: In the PCOS group, the abnormal response of insulin to glucose loading was suggested. AUC(insulin) may be a better index than others to evaluate insulin resistance in non-obese PCOSpatients.