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.


METHODS
Retrospective study.


METHODS
Gynecologic Outpatient Clinic of University Hospital, affiliated with Unit of Gynecologic Endocrinology.


METHODS
Totals of 201 lean and 198 overweight/obese (ov-ob) nondiabetic PCOS patients were retrospectively selected.


METHODS
None.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
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.
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Andrea
A
Morciano
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: f.romani@yahoo.it.
Federica
F
Romani
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Francesca
F
Sagnella
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Elisa
E
Scarinci
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Carola
C
Palla
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Francesca
F
Moro
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Anna
A
Tropea
Department of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart, Rome, Italy.
Caterina
C
Policola
Department of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart, Rome, Italy.
Silvia
S
Della Casa
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Maurizio
M
Guido
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Antonio
A
Lanzone
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Rosanna
R
Apa
D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013851:Thinness / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin
HOMA-M(120); Polycystic ovary syndrome; clamp; insulin resistance