title: Is insulin resistance an intrinsic defect in asian polycystic ovary syndrome?
abstract: OBJECTIVE
  Approximately 50% to 70% of women with polycystic ovary syndrome (PCOS) have some degree of insulin resistance, and obesity is known to worsen insulin resistance. Many metabolic consequences of PCOS are similar to those of obesity; therefore, defining the cause of insulin resistance in women can be difficult. Our objective was to clarify the factors contributing to insulin resistance in PCOS.
  
  
  METHODS
  We consecutively recruited 144 women with PCOS [age: 26±5 yr, body mass index, body mass index (BMI): 24.4±4.0 kg/m2] and 145 controls (age: 25±5 yr, BMI: 23.0±3.6 kg/m2), and divided them into overweight/obese (ow/ob, BMI≥23 kg/m2) and lean (BMI<23 kg/m2) groups. Anthropometric measures and a 75-g oral glucose tolerance test were performed, and insulin sensitivity index (ISI) was calculated as an index of insulin sensitivity. Factors predictive of ISI were determined using regression analysis.
  
  
  RESULTS
  ISI was significantly lower in both lean and ow/ob women with PCOS compared to BMI-matched controls (p<0.05). Increasing BMI by 1 kg/m2 decreased ISI by 0.169 in PCOS patients (p<0.05) and by 0.238 in controls (p<0.05); there was no significant difference between these groups. In lean PCOS patients and lean controls, BMI had no effect on ISI. Multiple regression analysis revealed that PCOS status (β=-0.423, p<0.001) and BMI (β=-0.375, p<0.001) were significantly associated with ISI.
  
  
  CONCLUSIONS
  Insulin resistance is an intrinsic defect of PCOS, and a high BMI could exacerbate insulin resistance in all women, irrespective of whether they have PCOS.
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea.
authors.forename: Hyejin
authors.initials: H
authors.lastname: Lee
authors.forename: Jee-Young
authors.initials: JY
authors.lastname: Oh
authors.forename: Yeon-Ah
authors.initials: YA
authors.lastname: Sung
authors.forename: Hyewon
authors.initials: H
authors.lastname: Chung
mesh_terms: D050154:Adiposity; D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D012044:Regression Analysis
chemical_list: D001786:Blood Glucose
keywords: Insulin resistance; body mass index; polycystic ovary syndrome
references.citation: J Clin Endocrinol Metab. 1996 Aug;81(8):2854-64
references.pmid: 8768842
references.citation: Diabetes Res Clin Pract. 2007 Sep;77 Suppl 1:S243-6
references.pmid: 17610984
references.citation: J Clin Endocrinol Metab. 1998 Sep;83(9):3078-82
references.pmid: 9745406
references.citation: BJOG. 2006 Oct;113(10):1148-59
references.pmid: 16827825
references.citation: Hum Reprod. 1995 Aug;10(8):2107-11
references.pmid: 8567849
references.citation: J Clin Endocrinol Metab. 1992 Aug;75(2):577-83
references.pmid: 1322430
references.citation: J Clin Epidemiol. 1998 May;51(5):415-22
references.pmid: 9619969
references.citation: Metabolism. 1994 Dec;43(12):1536-42
references.pmid: 7990708
references.citation: Med J Aust. 2012 Jan 16;196(1):62-6
references.pmid: 22256938
references.citation: J Clin Endocrinol Metab. 1998 Aug;83(8):2694-8
references.pmid: 9709933
references.citation: Diabetes Care. 2000 Mar;23(3):295-301
references.pmid: 10868854
references.citation: J Clin Endocrinol Metab. 1994 May;78(5):1052-8
references.pmid: 8175959
references.citation: Clin Endocrinol (Oxf). 1989 Jul;31(1):87-120
references.pmid: 2513151
references.citation: Am J Obstet Gynecol. 1992 Dec;167(6):1807-12
references.pmid: 1471702
references.citation: J Clin Endocrinol Metab. 2005 Oct;90(10):5711-6
references.pmid: 16046590
references.citation: Hum Reprod. 2004 Apr;19(4):757-9
references.pmid: 15033943
references.citation: J Clin Endocrinol Metab. 1995 Sep;80(9):2586-93
references.pmid: 7673399
references.citation: Fertil Steril. 2004 Jan;81(1):19-25
references.pmid: 14711538
references.citation: Horm Res. 2001;55(2):65-70
references.pmid: 11509861
references.citation: Fertil Steril. 2002 Jun;77(6):1095-105
references.pmid: 12057712
references.citation: J Clin Endocrinol Metab. 2010 May;95(5):2038-49
references.pmid: 20375205
references.citation: Hum Reprod Update. 2011 Jul-Aug;17(4):495-500
references.pmid: 21335359
references.citation: Hum Reprod Update. 2011 Nov-Dec;17(6):741-60
references.pmid: 21628302
references.citation: Clin Endocrinol (Oxf). 1992 Jan;36(1):105-11
references.pmid: 1559293
references.citation: J Clin Endocrinol Metab. 1987 Sep;65(3):499-507
references.pmid: 3305551
references.citation: J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45
references.pmid: 16940456
references.citation: Diabetes. 1989 Sep;38(9):1165-74
references.pmid: 2670645
references.citation: Diabetes Care. 1999 Jan;22(1):141-6
references.pmid: 10333916
references.citation: Endocr Rev. 2005 Apr;26(2):251-82
references.pmid: 15561799
references.citation: Clin Endocrinol (Oxf). 1990 Feb;32(2):213-20
references.pmid: 2112067
references.citation: Hum Reprod. 2010 Feb;25(2):544-51
references.pmid: 19910321
references.citation: N Engl J Med. 2005 Mar 24;352(12):1223-36
references.pmid: 15788499
references.citation: J Clin Endocrinol Metab. 1999 Nov;84(11):4006-11
references.pmid: 10566641
references.citation: Endocrinol Metab Clin North Am. 1999 Jun;28(2):341-59
references.pmid: 10352922
references.citation: Endocr Rev. 1997 Dec;18(6):774-800
references.pmid: 9408743
references.citation: J Clin Endocrinol Metab. 1999 Oct;84(10):3666-72
references.pmid: 10523012
references.citation: Hum Reprod. 2000 Jun;15(6):1266-74
references.pmid: 10831553
references.citation: Public Health Nutr. 2009 Apr;12(4):497-506
references.pmid: 18547457
references.citation: Recent Prog Horm Res. 2001;56:295-308
references.pmid: 11237218