title: Association of obesity and overweight with the prevalence of insulin resistance, pre-diabetes and clinical-biochemical characteristics among infertile Mexican women with polycystic ovary syndrome: a cross-sectional study.
abstract: To study the association of obesity and overweight with the prevalence of insulin resistance (IR), pre-diabetes and clinical-biochemical characteristics among infertile Mexican women with polycystic ovary syndrome (PCOS).
  
  
  
  Retrospective cross-sectional study.
  
  
  
  Level-three medical institution, an infertility clinic in Mexico City.
  
  
  
  We included infertile Mexican women with diagnosis of PCOS according to the Rotterdam criteria: group 1 (n=83), normal weight (body mass index (BMI) 18.5-24.9 kg/m(2)); group 2 (n=217), overweight (BMI 25-29.9 kg/m(2)); and group 3 (n=238), obese (BMI≥30 kg/m(2)).
  
  
  
  IR was determined by homeostatic model assessment (HOMA) >2.5 and pre-diabetes by fasting glucose between 5.6 and 6.9 mmol/L and/or glucose value between 7.8 and 11 mmol/L at 2 hours during an oral glucose tolerance test. We compared clinical-biochemical characteristics among groups.
  
  
  
  Prevalence of IR for groups 1, 2 and 3 was 19.3%, 56.2% and 78.2%; overweight and obesity increase the IR OR (CI 95%) to 5.3 (2.9 to 9.8) and 14.9 (8.0 to 28), respectively. Prevalence of pre-diabetes for groups 1, 2 and 3 was 7.2%, 17.5% and 31.5%; overweight and obesity increase the pre-diabetes OR (CI 95%) to 2.7 (1.1 to 6.7) and 5.9 (2.4 to 14), respectively. Acanthosis nigricans was more frequent in group 3 than group 1. Free Androgen Index (FAI) and thyroid-stimulating hormone (TSH) levels were lower in group 1 than in groups 2 and 3. Progesterone and sex hormone-binding globulin (SHBG) levels were higher in group 1 than in groups 2 and 3. Dehydroepiandrosterone sulfate (DHEA-S) was higher in group 1 than group 3.
  
  
  
  Obese and overweight infertile Mexican women with PCOS, attending to an infertility clinic, have a higher prevalence of IR and pre-diabetes compared with normal-weight women with PCOS. Therapeutic interventions should include those that improved metabolic functioning prior to attempting pregnancy in these groups of women.
authors.affiliation: Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Enrique
authors.initials: E
authors.lastname: Reyes-Muñoz
authors.affiliation: Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ortega-González
authors.affiliation: Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Nayeli
authors.initials: N
authors.lastname: Martínez-Cruz
authors.affiliation: Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Lidia
authors.initials: L
authors.lastname: Arce-Sánchez
authors.affiliation: Biomedical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Estrada-Gutierrez
authors.affiliation: Research Unit of Reproductive Medicine, Health Research Council, Mexican Institute of Social Security, IMSS, Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Moran
authors.affiliation: Division of Reproductive Medicine, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Ana Paola
authors.initials: AP
authors.lastname: Sánchez-Serrano
authors.affiliation: Division of Reproductive Medicine, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Higareda-Sánchez
authors.affiliation: Division of Reproductive Medicine, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico.
authors.forename: Julio Francisco
authors.initials: JF
authors.lastname: de la Jara-Díaz
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000150:complications*; D007333:Insulin Resistance; D008800:Mexico; D009765:Obesity / Q000097:blood / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D011236:Prediabetic State / Q000097:blood / Q000150:complications*; D055815:Young Adult
keywords: insulin resistance; obesity; polycystic ovary syndrome; prediabetes