title: Screening for insulin resistance in women with polycystic ovarian syndrome.
abstract: BACKGROUND
  Insulin resistance is implicated in the pathogenesis of polycystic ovarian syndrome (PCOS). Insulin-sensitizing agents are increasingly used in the treatment of infertility and hirsutism in PCOS. However, not all women with PCOS are insulin-resistant.
  
  
  OBJECTIVE
  To assess the degree of insulin resistance within a clinic population of women referred for treatment of oligomenorrhoea or infertility.
  
  
  METHODS
  We evaluated 25 consecutive PCOS outpatients referred for treatment of menstrual dysfunction/infertility and a matched control group. All underwent a standard oral glucose tolerance test (OGTT) with serial insulin measurements. Insulin sensitivity was calculated using homeostasis model assessment (HOMA).
  
  
  RESULTS
  Five of the 25 clinic patients had abnormal glucose handling (two had previously unknown type 2 diabetes and three had impaired glucose tolerance). Fasting and 2-h insulin levels were significantly higher in the PCOS women. Mean HOMA-S (insulin sensitivity) was even lower for PCOS women with normal GTT status (mean (95% confidence interval): 0.53 (0.34-0.72)) than for controls (0.94 (0.84-1.04)) (F = 4.2, p < 0.001). HOMA-B (pancreatic beta-cell function) was nearly tripled for normal GTT status PCOS women at 273 (205-342) versus 105 (70-139) for controls (F = 6.8, p < 0.001).
  
  
  CONCLUSIONS
  The results suggest a role for routine measurement of HOMA-S in identifying women with PCOS with insulin resistance with a view to targeting them with insulin-sensitizing agents.
authors.affiliation: Department of Endocrinology, University of Manchester, Salford NHS Trust, Salford, UK. aheald@fs1.ho.man.ac.uk
authors.forename: Adrian
authors.initials: A
authors.lastname: Heald
authors.forename: Sharon
authors.initials: S
authors.lastname: Whitehead
authors.forename: Simon
authors.initials: S
authors.lastname: Anderson
authors.forename: Kennedy
authors.initials: K
authors.lastname: Cruickshank
authors.forename: Lisa
authors.initials: L
authors.lastname: Riste
authors.forename: Ian
authors.initials: I
authors.lastname: Laing
authors.forename: Aram
authors.initials: A
authors.lastname: Rudenski
authors.forename: Helen
authors.initials: H
authors.lastname: Buckler
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000097:blood*
chemical_list: D015415:Biomarkers; D007328:Insulin