Abnormal response of insulin to glucose loading and assessment of insulin resistance in non-obese patients with polycystic ovary syndrome.
OBJECTIVE
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.


CONCLUSIONS
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.
Takeuchi
Toru
T
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. takeuchi-dis@h.u-tokyo.ac.jp
Tsutsumi
Osamu
O
Taketani
Yuji
Y
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D013739:Testosterone / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone