Prevalence of insulin resistance in Korean women with polycystic ovary syndrome according to various homeostasis model assessment for insulin resistance cutoff values

Using a homeostasis model assessment for insulin resistance cutoff value predicting metabolic syndrome, 65% of women with polycystic ovary syndrome were not insulin resistant and showed similar metabolic features compared with controls.

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Volume 112, Issue 5, Pages 959–966.e1

Authors:

Jin Ju Kim, M.D., Ph.D., Kyu Ri Hwang, M.D., Ph.D., So Hee Oh, Ph.D., Soo Jin Chae, M.D., Ph.D., Sang Ho Yoon, M.D., Ph.D., Young Min Choi, M.D., Ph.D.

Abstract:

Objective

To investigate the various homeostasis model assessment for insulin resistance (HOMA-IR) cutoff values in a large population of healthy controls and to evaluate the prevalence of IR in women with polycystic ovary syndrome (PCOS).

Design

Case control study.

Setting

Reproductive endocrinology center.

Patient(s)

Women with (n = 699) and without PCOS (n = 572).

Intervention(s)

Blood tests.

Main Outcome Measure(s)

The upper 75th and 95th percentiles of HOMA-IR in lean controls (n = 522) and the HOMA-IR cutoff that indicates metabolic risk in all participants.

Result(s)

HOMA-IR cutoffs of 1.82 and 3.16 were defined as above the 75th and 95th percentiles in lean controls, and the prevalence of IR in patients with PCOS was 60.7% and 24.5%, respectively. The optimal HOMA-IR for the diagnosis of metabolic syndrome was 2.64; thus, metabolic risk was increased at a lower level of HOMA-IR compared with the 95th percentile cutoff. At HOMA-IR cutoff of 2.64, 34.8% of patients with PCOS had evidence of IR. Metabolic features significantly differed between patients with PCOS with and without IR, and patients with PCOS without IR showed similar or more favorable metabolic features compared with controls. Overweight/obese patients are the most high-risk group, but lean patients also showed a similarly elevated prevalence of IR as overweight/obese controls. A positive correlation was observed between BMI and HOMA-IR in both patients and controls, but the magnitude was significantly greater in patients than in controls.

Conclusion(s)

Although IR is common in women with PCOS, it does not seem to be universal, and patients without IR had reassuring metabolic features.


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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