J Menopausal Med.  2014 Dec;20(3):104-110. 10.6118/jmm.2014.20.3.104.

Clinical and Biochemical Profiles according to Homeostasis Model Assessment-insulin Resistance (HOMA-IR) in Korean Women with Polycystic Ovary Syndrome

• Lee DE
• Park SY
• Park SY
• Lee SR
• Chung HW
• Jeong K

• KMID: 2325471
• DOI: http://doi.org/10.6118/jmm.2014.20.3.104

Abstract

OBJECTIVES
The aim of this study was to investigate the clinical and biochemical profiles according to homeostasis model assessment of insulin resistance (HOMA-IR) in Korean polycystic ovary syndrome (PCOS) patients.
METHODS
In 458 PCOS patients diagnosed by the Rotterdam European Society for Human Reproduction and Embryology (ESHRE) criteria, measurements of somatometry, blood test of hormones, glucose metabolic and lipid profiles, and transvaginal or transrectal ultrasonogram were carried out. HOMA-IR was then calculated and compared with the clinical and biochemical profiles related to PCOS. The patients were divided into 4 groups by quartiles of HOMA-IR.
RESULTS
The mean level of HOMA-IR was 2.18 +/- 1.73. Among the four groups separated according to HOMA-IR, body weight, body mass index (BMI), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, lipid accumulation product (LAP) index, high-sensitivity C-reactive protein (hs-CRP), Apoprotein B, free testosterone, and sex hormone binding globulin (SHBG) were found to be significantly different. TG, LAP index, glucose metabolic profiles, and hs-CRP were positively correlated with HOMA-IR after adjustment for BMI.
CONCLUSION
Our results suggest that the clinical and biochemical profiles which are applicable as cardiovascular risk factors are highly correlated with HOMA-IR in Korean women with PCOS.

Keyword

Cardiovascular diseases; Homeostasis; Insulin resistance; Polycystic ovary syndrome; Risk factors

MeSH Terms

Apoproteins
Body Mass Index
Body Weight
C-Reactive Protein
Cardiovascular Diseases
Cholesterol
Embryology
Female
Glucose
Hematologic Tests
Homeostasis*
Humans
Insulin Resistance
Lipid Accumulation Product
Lipoproteins
Metabolome
Polycystic Ovary Syndrome*
Reproduction
Risk Factors
Sex Hormone-Binding Globulin
Testosterone
Triglycerides
Ultrasonography
Waist-Hip Ratio
Apoproteins
C-Reactive Protein
Cholesterol
Glucose
Lipoproteins
Sex Hormone-Binding Globulin
Testosterone

Reference

1. Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007; 370:685–697.

2. Scicchitano P, Dentamaro I, Carbonara R, Bulzis G, Dachille A, Caputo P, et al. Cardiovascular Risk in Women With PCOS. Int J Endocrinol Metab. 2012; 10:611–618.

3. Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls. Obstet Gynecol Surv. 2004; 59:141–154.

4. Nawrocka-Rutkowska J, Ciećwież S, Marciniak A, Brodowska A, Wiśüniewska B, Kotlega D, et al. Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteria-impact of metformin treatment. Ann Agric Environ Med. 2013; 20:528–532.

5. Wallace TM, Matthews DR. The assessment of insulin resistance in man. Diabet Med. 2002; 19:527–534.

6. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81:19–25.

7. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. Geneva, CH: World Health Organization;2012. Cited by 2012 April 20. Available from: http://whqlibdoc.who.int/publications/2011/9789241501491_eng.pdf.

8. Galluzzo A, Amato MC, Giordano C. Insulin resistance and polycystic ovary syndrome. Nutr Metab Cardiovasc Dis. 2008; 18:511–518.

9. El-Mazny A, Abou-Salem N, El-Sherbiny W, El-Mazny A. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet. 2010; 109:239–241.

10. Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, Chrousos GP. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab. 2007; 18:280–285.

11. Kahn HS. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord. 2005; 5:26.

12. Wiltgen D, Benedetto IG, Mastella LS, Spritzer PM. Lipid accumulation product index: a reliable marker of cardiovascular risk in polycystic ovary syndrome. Hum Reprod. 2009; 24:1726–1731.

13. Pesant MH, Baillargeon JP. Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome. Fertil Steril. 2011; 95:210–215.

14. Alebić MS, Bulum T, Stojanović N, Duvnjak L. Definition of insulin resistance using the homeostasis model assessment (HOMA-IR) in IVF patients diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria. Endocrine. 2014; 47:625–630.

15. Han M. Metabolic syndrome emerging from menopause. J Korean Soc Menopause. 2011; 17:127–135.

16. Namkung J, Kim JH, Jo HH, Oh EK, Cheon K, Kwon DJ, et al. Comparison of the effects of hormone replacement therapy on bone mineral density, lipid profiles, and biochemical markers of bone metabolism. J Korean Soc Menopause. 2010; 16:107–115.

17. Welt CK, Carmina E. Clinical review: Lifecycle of polycystic ovary syndrome (PCOS): from in utero to menopause. J Clin Endocrinol Metab. 2013; 98:4629–4638.

18. Carmina E. Polycystic ovary syndrome: metabolic consequences and long-term management. Scand J Clin Lab Invest Suppl. 2014; 244:23–26.

19. Carmina E, Campagna AM, Lobo RA. A 20-year follow-up of young women with polycystic ovary syndrome. Obstet Gynecol. 2012; 119:263–269.

20. Schmidt J, Landin-Wilhelmsen K, Brännström M, Dahlgren E. Cardiovascular disease and risk factors in PCOS women of postmenopausal age: a 21-year controlled follow-up study. J Clin Endocrinol Metab. 2011; 96:3794–3803.

21. Shah D, Bansal S. Polycystic ovaries - beyond menopause. Climacteric. 2014; 17:109–115.