Assessment of insulin resistance in lean women with polycystic ovary syndrome.
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.
['Morciano|Andrea|A|', 'Romani|Federica|F|', 'Sagnella|Francesca|F|', 'Scarinci|Elisa|E|', 'Palla|Carola|C|', 'Moro|Francesca|F|', 'Tropea|Anna|A|', 'Policola|Caterina|C|', 'Della Casa|Silvia|S|', 'Guido|Maurizio|M|', 'Lanzone|Antonio|A|', 'Apa|Rosanna|R|']
D000293:Adolescent D000328:Adult D019540:Area Under Curve D015415:Biomarkers D001786:Blood Glucose D005260:Female D015309:Glucose Clamp Technique D005951:Glucose Tolerance Test D006801:Humans D007328:Insulin D007333:Insulin Resistance D009765:Obesity D011085:Polycystic Ovary Syndrome D011237:Predictive Value of Tests D012372:ROC Curve D015203:Reproducibility of Results D012189:Retrospective Studies D013851:Thinness D055815:Young Adult
insulin resistance Polycystic ovary syndrome clamp HOMA-M(120)