Jin Ju Kim1, Kyu Ri Hwang2, So Hee Oh3, Soo Jin Chae4, Sang Ho Yoon5, Young Min Choi6. 1. Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea. 3. Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea. 4. Department of Obstetrics and Gynecology, Maria Fertility Hospital, Seoul, Republic of Korea. 5. Department of Obstetrics and Gynecology, School of Medicine, Dongguk University, Seoul, Republic of Korea. 6. Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: ymchoi@snu.ac.kr.
Abstract
OBJECTIVE: To investigate the various homeostasis model assessment for insulin resistance (HOMA-IR) cutoff values in a large population of healthy controls and to evaluate the prevalence of IR in women with polycystic ovary syndrome (PCOS). DESIGN: Case control study. SETTING: Reproductive endocrinology center. PATIENT(S): Women with (n = 699) and without PCOS (n = 572). INTERVENTION(S): Blood tests. MAIN OUTCOME MEASURE(S): The upper 75th and 95th percentiles of HOMA-IR in lean controls (n = 522) and the HOMA-IR cutoff that indicates metabolic risk in all participants. RESULT(S): HOMA-IR cutoffs of 1.82 and 3.16 were defined as above the 75th and 95th percentiles in lean controls, and the prevalence of IR in patients with PCOS was 60.7% and 24.5%, respectively. The optimal HOMA-IR for the diagnosis of metabolic syndrome was 2.64; thus, metabolic risk was increased at a lower level of HOMA-IR compared with the 95th percentile cutoff. At HOMA-IR cutoff of 2.64, 34.8% of patients with PCOS had evidence of IR. Metabolic features significantly differed between patients with PCOS with and without IR, and patients with PCOS without IR showed similar or more favorable metabolic features compared with controls. Overweight/obese patients are the most high-risk group, but lean patients also showed a similarly elevated prevalence of IR as overweight/obese controls. A positive correlation was observed between BMI and HOMA-IR in both patients and controls, but the magnitude was significantly greater in patients than in controls. CONCLUSION(S): Although IR is common in women with PCOS, it does not seem to be universal, and patients without IR had reassuring metabolic features.
OBJECTIVE: To investigate the various homeostasis model assessment for insulin resistance (HOMA-IR) cutoff values in a large population of healthy controls and to evaluate the prevalence of IR in women with polycystic ovary syndrome (PCOS). DESIGN: Case control study. SETTING: Reproductive endocrinology center. PATIENT(S): Women with (n = 699) and without PCOS (n = 572). INTERVENTION(S): Blood tests. MAIN OUTCOME MEASURE(S): The upper 75th and 95th percentiles of HOMA-IR in lean controls (n = 522) and the HOMA-IR cutoff that indicates metabolic risk in all participants. RESULT(S): HOMA-IR cutoffs of 1.82 and 3.16 were defined as above the 75th and 95th percentiles in lean controls, and the prevalence of IR in patients with PCOS was 60.7% and 24.5%, respectively. The optimal HOMA-IR for the diagnosis of metabolic syndrome was 2.64; thus, metabolic risk was increased at a lower level of HOMA-IR compared with the 95th percentile cutoff. At HOMA-IR cutoff of 2.64, 34.8% of patients with PCOS had evidence of IR. Metabolic features significantly differed between patients with PCOS with and without IR, and patients with PCOS without IR showed similar or more favorable metabolic features compared with controls. Overweight/obesepatients are the most high-risk group, but lean patients also showed a similarly elevated prevalence of IR as overweight/obese controls. A positive correlation was observed between BMI and HOMA-IR in both patients and controls, but the magnitude was significantly greater in patients than in controls. CONCLUSION(S): Although IR is common in women with PCOS, it does not seem to be universal, and patients without IR had reassuring metabolic features.
Authors: Hee Sun Kim; Heejin Lee; Sherlyn Mae P Provido; Minji Kang; Grace H Chung; Sangmo Hong; Sung Hoon Yu; Chang Beom Lee; Jung Eun Lee Journal: Front Public Health Date: 2021-07-01