Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteria--impact of metformin treatment.
OBJECTIVE
Polycystic ovary syndrome (PCOS) is one of the most frequent reasons for anovulation in infertile women. It can affect 5%-10% of women of reproductive age. One of the important factors associated with the typical clinical signs and hormonal disorders could be insulin resistance and hyperinsulinaemia. The primary objective of this study was to assess the prevalence of insulin resistance in PCOS women. The secondary objective was to evaluate changes in body mass index (BMI), waist-to-hip ratio (WHR), and insulin sensitivity after 3 months of metformin therapy.


METHODS
68 patients were enrolled in the study. In all participants fasting and 2-h post-load glucose and insulin levels, WHR and BMI were evaluated before and after metformin (2 x 850 mg) therapy. Insulin resistance was assessed using G0/I0, G120/I120, and HOMA-IR indexes.


RESULTS
Before the treatment, insulin resistance was observed in 26% patients according to HOMA-IR, and in 16% or 28% according to G0/I0 or G120/I120, respectively. Metformin therapy was associated with improvement in insulin sensitivity in HOMA-IR and G120/I120 defined insulin resistant patients.


CONCLUSIONS
The percentage of insulin resistant PCOS patients differed depending on the method applied. It is necessary to find a single most useful method to measure insulin resistance. Metformin treatment significantly improves insulin sensitivity in insulin resistant patients.
Department of Gynaecology and Urogynaecology, Pomeranian Medical University, Szczecin, Poland.
Jolanta
J
Nawrocka-Rutkowska
Sylwester
S
Ciećwież
Aleksandra
A
Marciniak
Agnieszka
A
Brodowska
Berenika
B
Wiśniewska
Dariusz
D
Kotlega
Andrzej
A
Starczewski
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D011044:Poland / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology*; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin