Correlation of Homeostatic Model Assessment-Insulin Resistance, Anti-Mullerian Hormone, and BMI in the Characterization of Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is the commonest cause of chronic hyperandrogenic anovulation. Insulin resistance and compensatory hyperinsulinemia are keys of the pathogenesis of PCOS. It is also considered as a metabolic disorder. Since the components of metabolic syndrome (MBS) namely obesity, glucose intolerance, dyslipidemia, and hypertension are the common features of this syndrome. The association between MBS and PCOS can be explained by different theories as insulin resistance, obesity, and related adipose tissue factors (adipocytokines) independent of insulin resistance are the main pathogenic contributors to both disorders.Methods: A total of 143 women with PCOS were recruited as study subjects. All participants were subjected to anthropometric measurements, clinical assessment, and biochemical tests [fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance (HOMA-IR)]. Hormonal profile particularly leptin and homocysteine levels were also evaluated.Results: 25 patients (17.4%) out of 143 women with PCOS met the criteria for MBS. Patients with MBS had significantly higher body mass index, blood pressure, HOMA-IR, leptin, and homocysteine levels compared to PCOS only patients. When HOMA-IR cut off was ≥4.3 sensitivity and specificity were 90%, 88.6%, but when leptin level was ≥34.5 the corresponding statistics were 79.6%, 75.5%.Conclusions: Serum leptin, homocysteine, HOMA-IR as well as other biochemical markers are significantly higher in women with PCOS and MBS compared to PCOS only women. PCOS is associated with various factors like insulin resistance, obesity, and dyslipidemia. Consequently, adipocytokines and HOMA-IR play important role in the prediction of MBS in patients with PCOS.

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Polycystic ovary syndrome: implications of metabolic dysfunction

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912014000200006 ◽

2014 ◽

Vol 41 (2) ◽

pp. 106-110

Author(s):

Márcio Augusto Pinto de Ávila ◽

Ricardo Vasconcellos Bruno ◽

Fábio Cuiabano Barbosa ◽

Felipe Cupertino de Andrade ◽

Adriana Cardoso de Oliveira e Silva ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

The State ◽

Model Assessment ◽

Metabolic Dysfunction ◽

Ovary Syndrome ◽

Cross Sectional ◽

Homeostatic Model Assessment ◽

Routine Inspection

OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and its clinical interrelations in polycystic ovary syndrome (PCOS).METHODS: This was a cross-sectional, prospective study with 100 patients with diagnosed PCOS based on the consensus of Rotterdam (2003). We investigated the interrelationships of MS, with intrinsic PCOS data. Dermatological profile was analyzed, in addition to acanthosis nigricans (AN) in the presence of hirsutism and acne. The use of HOMA-IR (homeostatic model assessment of insulin resistance) aimed at the correlation with MS in order to establish the metabolic dysfunction with the state of insulin resistance.RESULTS: The mean and standard deviations corresponding figures for age, body mass index and waist circumference were, respectively, 25.72 (± 4.87), 30.63 (± 9.31) and 92.09 (± 18.73). The prevalence of MS was 36% and significantly correlated with BMI, AN, and in 51% of patients the state of insulin resistance (HOMA-IR). Regarding skin profile, only AN significant correlation with MS.CONCLUSION: We propose the routine inspection of metabolic components related to severe PCOS. These parameters configure the cardiovascular risk and such conduct is of undoubted importance to public health.

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Failure of the homeostatic model assessment calculation score for detecting metabolic deterioration in young patients with polycystic ovary syndrome

Fertility and Sterility ◽

10.1016/j.fertnstert.2006.01.024 ◽

2006 ◽

Vol 86 (2) ◽

pp. 398-404 ◽

Cited By ~ 19

Author(s):

Anna Maria Fulghesu ◽

Stefano Angioni ◽

Elaine Portoghese ◽

Francesca Milano ◽

Barbara Batetta ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Young Patients ◽

Model Assessment ◽

Ovary Syndrome ◽

Homeostatic Model Assessment ◽

Homeostatic Model

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Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211031758 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110317

Author(s):

Chenyun Miao ◽

Qingge Guo ◽

Xiaojie Fang ◽

Yun Chen ◽

Ying Zhao ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Confidence Interval ◽

Polycystic Ovary ◽

Serum Insulin ◽

Meta Analysis ◽

Mean Difference ◽

Model Assessment ◽

Ovary Syndrome ◽

Synbiotic Supplementation

Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.

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Serum Testosterone to Androstenedione Ratio Predicts Metabolic Health in Normal-Weight Polycystic Ovary Syndrome Women

Journal of the Endocrine Society ◽

10.1210/jendso/bvab158 ◽

2021 ◽

Author(s):

Daniel A Dumesic ◽

Ayli Tulberg ◽

Megan McNamara ◽

Tristan R Grogan ◽

David H Abbott ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Elevated Serum ◽

Normal Weight ◽

Model Assessment ◽

Metabolic Function ◽

Ovary Syndrome ◽

Intravenous Glucose

Abstract Context Increased aldo-keto reductase 1C3 (AKR1C3)-mediated conversion of androstenedione (A4) to testosterone (T) promotes lipid storage in subcutaneous (SC) abdominal adipose in overweight/obese polycystic ovary syndrome (PCOS) women. Objective To examine whether an elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts metabolic function in normal-weight PCOS women. Design Prospective cohort study. Setting Academic center. Patients Nineteen normal-weight PCOS women; 21 age- and body mass index-matched controls. Intervention(s) Circulating hormone/metabolic determinations, intravenous glucose tolerance testing, total body dual-energy x-ray absorptiometry, SC abdominal fat biopsy. Main Outcome Measure(s) Serum T/A4 ratios, hormone/metabolic measures and AKR1C3 expression of adipocytes matured in vitro were compared between female types; serum T/A4 ratios were correlated with serum lipids, adipose insulin resistance (adipose-IR), homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity (Si). Results Increased serum T/A4 ratios (P=0.040) and log adipose-IR values (P=0.002) in PCOS women versus controls were accompanied by AKR1C3 mRNA overexpression of PCOS adipocytes matured in vitro (P=0.016). Serum T/A4 ratios in PCOS women, but not controls, negatively correlated with log triglycerides (TG: R=-0.65, P=0.002) and the TG index (R=-0.57, P=0.011). Adjusting for serum free T, serum T/A4 ratios in PCOS women remained negatively correlated with log TG (R=-0.57, P=0.013) and TG index (R=-0.50, P=0.036), respectively, without significant relationships with other metabolic measures. Conclusion An elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts healthy metabolic function in normal-weight PCOS women.

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Endotrophin as a novel marker in PCOS and its relation with other adipokines and metabolic parameters: a pilot study

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/20420188211049607 ◽

2021 ◽

Vol 12 ◽

pp. 204201882110496

Author(s):

Gurhan Guney ◽

Mine Islimye Taskin ◽

Ozgur Baykan ◽

Ertan Adali ◽

Selin Gul Tezcan ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Density Lipoprotein ◽

Resistance Index ◽

Total Testosterone ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Ovary Syndrome ◽

Significant Difference

Background: Polycystic ovary syndrome is known to be the most common hormonal disorder in women of reproductive age. Current evidence shows that regulatory proteins secreted from the adipose tissue called adipokines may have a role in polycystic ovary syndrome. We planned to investigate the role of endotrophin that has never been researched in polycystic ovary syndrome before and its correlation with other metabolic parameters and adipokines such as adiponectin and ghrelin in patients with polycystic ovary syndrome. Methods: Forty-three women ( n: 43) with polycystic ovary syndrome and 43 ( n: 43) women as a control group were enrolled in this cross-sectional study. Serum levels of endotrophin, adiponectin, and ghrelin levels were measured with the enzyme-linked immunosorbent assay method. High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol levels, luteinizing hormone/follicle-stimulating hormone ratio, total testosterone, and triglyceride levels were measured. Homeostasis model assessment for insulin resistance index, body mass index, Ferriman Gallwey Score, and waist-to-hip ratio were also evaluated. Results: Total testosterone, homeostasis model assessment for insulin resistance, C-reactive protein, luteinizing hormone/follicle-stimulating hormone ratio, and triglyceride levels were higher in patients with polycystic ovary syndrome ( p < 0.01). No difference was detected between the groups in terms of body mass index, Ferriman Gallwey Score, waist-to-hip ratio, total cholesterol, low-density lipoprotein, and high-density lipoprotein levels ( p > 0.05). We did not observe any significant difference in adiponectin and ghrelin levels between the groups ( p > 0.05). Patients with polycystic ovary syndrome had significantly higher endotrophin levels ( p < 0.01). According to our regression analyses [area under the curve: 0.973 (0.935–1.000), 95% confidence interval, 95.2% sensitivity, and 100% specificity], it was shown that endotrophin greater than 92 ng/ml and homeostasis model assessment for insulin resistance greater than 2.5 might be good predictors for polycystic ovary syndrome diagnosis. Conclusion: We demonstrated that endotrophin level is higher in patients with polycystic ovary syndrome and may have predicted polycystic ovary syndrome with increased homeostasis model assessment for insulin resistance index. There was no significant difference in adiponectin and ghrelin levels in the polycystic ovary syndrome group. Endotrophin may have a role in polycystic ovary syndrome etiology rather than other adipokines.

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Thyroid-stimulating Hormone and Insulin Resistance: Their Association with Polycystic Ovary Syndrome without Overt Hypothyroidism

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1601436 ◽

2017 ◽

Vol 39 (05) ◽

pp. 224-228 ◽

Cited By ~ 1

Author(s):

Cristina Benetti-Pinto ◽

Vanessa Piccolo ◽

Daniela Yela ◽

Heraldo Garmes

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Thyroid Stimulating Hormone ◽

Metabolic Parameters ◽

Overt Hypothyroidism ◽

Model Assessment ◽

Ovary Syndrome ◽

Cross Sectional ◽

Stimulating Hormone

Objective This study analyzed the effectiveness of the thyroid-stimulating hormone (TSH) as a predictor of insulin resistance (IR) and its association with the clinical and metabolic parameters of women with polycystic ovary syndrome (PCOS) without overt hypothyroidism. Study Design A cross-sectional study was performed. Women with PCOS and without overt hypothyroidism (n = 168) were included. Methods Receiver operating characteristic (ROC) curve was used to determine the cut-off point for TSH that would maximize sensitivity and specificity for a diagnosis of IR using homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 2.71. Clinical and metabolic parameters were compared as a function of the TSH cut-off limit and the presence of IR. Results Thyroid-stimulating hormone ≥ 2.77 mIU/L was associated with a diagnosis of IR, with sensitivity of 47.9% and specificity of 65.3%. There were no differences in clinical, hormonal or metabolic parameters between TSH < 2.77 and TSH of 2.77 – 10 mIU/L. Conclusion In women with PCOS without overt hypothyroidism, TSH ≥ 2.77 mIU/L is associated with IR; however, with poor sensibility, showing TSH to be a poor predictor of IR in this population. No clinical or metabolic alterations were found that would justify a change in clinical management. Thus, the IR should be investigated in all women with PCOS irrespective of TSH level.

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Association of oral contraceptive and metformin did not improve insulin resistance in women with polycystic ovary syndrome

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.61.03.215 ◽

2015 ◽

Vol 61 (3) ◽

pp. 215-219 ◽

Cited By ~ 4

Author(s):

Margareth Chiharu Iwata ◽

Livia Porquere ◽

Isabel C. Espósito Sorpreso ◽

Edmund C. Baracat ◽

José Maria Soares Júnior

Keyword(s):

Insulin Resistance ◽

Oral Contraceptive ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Total Testosterone ◽

Model Assessment ◽

Cycle Index ◽

Androgen Excess ◽

Ovary Syndrome ◽

Improve Insulin Resistance

Summary Objective: Objective: to compare clinical and laboratory parameters in women with polycystic ovary syndrome (PCOS) using metformin or combined oral contraceptive (COC) after 6 months. Methods: retrospective study analyzing records of patients with PCOS using the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society criteria. The groups were: I-COC (21 tablets, pause of 7 days; n=16); II-metformin (850mg 12/12h, n=16); III-COC plus metformin (n=9). Body mass index (BMI), acne (% of improvement), modified Ferriman-Gallway index and menstrual cycle index (MCI), luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), androstenedione (A) and homeostasis model assessment: insulin resistance (HOMA-IR) index were assessed Results: isolated use of COC compared to metformin was better regarding to acne, Ferriman index, MCI, LH, TT and A levels. On the other hand, metformin was better in the HOMA-IR index (4.44 and 1.67 respectively, p=0.0007). The association COC plus metformin, compared to metformin alone shows the maintenance of improvement of acne, Ferriman index, MCI, and testosterone levels. The HOMA-IR index remained lower in the metformin alone group (4.19 and 1.67, respectively; p=0,046). The comparison between COC plus metformin and COC alone, in turn, shows no difference in the improvement of acne, Ferriman index, MCI, LH, TT and A levels, indicating that the inclusion of metformin did not lead to additional benefits in these parameters. Still, the HOMA-IR index was similar in both groups (4.19 and 4.44 respectively; p=0.75), showing that the use of metformin associated with COC may not improve insulin resistance as much as it does if used alone. Conclusion: our data suggest that the combination of metformin and contraceptive does not improve insulin resistance as observed with metformin alone.

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Circulating FGF21 levels are related to nutritional status and metabolic but not hormonal disturbances in polycystic ovary syndrome

Acta Endocrinologica ◽

10.1530/eje-14-0539 ◽

2015 ◽

Vol 172 (2) ◽

pp. 173-179 ◽

Cited By ~ 7

Author(s):

Magdalena Olszanecka-Glinianowicz ◽

Paweł Madej ◽

Michał Wdowczyk ◽

Aleksander Owczarek ◽

Jerzy Chudek

Keyword(s):

Insulin Resistance ◽

Waist Circumference ◽

Polycystic Ovary Syndrome ◽

Nutritional Status ◽

Polycystic Ovary ◽

Fibroblast Growth Factor 21 ◽

Model Assessment ◽

Fat Percentage ◽

Anthropometric Parameters ◽

Ovary Syndrome

ObjectiveThe aim of this study was to analyse relationships between plasma fibroblast growth factor 21 (FGF21) levels and nutritional status, and metabolic and hormonal disturbances in polycystic ovary syndrome (PCOS) women.Design and settingA cross-sectional study involving 85 PCOS (48 obese) and 72 non-PCOS women (41 obese) was conducted to evaluate the relationship between FGF21 levels and PCOS.MethodsAnthropometric parameters and body composition were determined. In the fasting state; serum concentrations of glucose, androgens, FSH, LH, SHBG, insulin and FGF21 were measured.ResultsPlasma FGF21 levels were significantly higher in obese women compared with normal-weight women in both PCOS and non-PCOS subgroups (120.3 (18.2–698) vs 62.3 (16.4–323.6) pg/ml, P<0.05 and 87.2 (12.9–748.4) vs 62.9 (18.0–378.8) pg/ml, P<0.05 respectively). Additionally, circulating FGF21 levels were significantly higher in the obese PCOS subgroup compared with the non-PCOS subgroup (120.3 (18.2–698.0) vs 87.2 (12.9–748.4) pg/ml, P<0.05). Circulating FGF21 levels were proportional to BMI (R=0.27; P<0.001), body fat mass (R=0.24; P<0.01) and percentage (R=0.24; P<0.01), as well as waist circumference (R=0.26; P<0.01). Additionally, plasma insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were related to FGF21 levels (R=0.44; P<0.001 and R=0.19; P<0.05 respectively). In multiple regression analysis, circulating FGF21 level variability was explained by HOMA-IR values and fat percentage, as well as waist circumference, but not correlated with oestradiol levels and free androgen index values.ConclusionsHigher circulating FGF21 levels are related to nutritional status and insulin resistance independent of PCOS. Increased FGF21 is associated with metabolic but not hormonal disturbances.

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Mean platelet volume and polycystic ovary syndrome: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211067316 ◽

2022 ◽

Vol 50 (1) ◽

pp. 030006052110673

Author(s):

Li Li ◽

Jianxiu Yu ◽

Zhongwei Zhou

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Mean Platelet Volume ◽

Polycystic Ovary ◽

Meta Analysis ◽

Effect Estimate ◽

Model Assessment ◽

Turkish Women ◽

Platelet Volume ◽

Ovary Syndrome

Objective This meta-analysis evaluated the association between the mean platelet volume (MPV) and polycystic ovary syndrome (PCOS). Methods A systematic literature search using PubMed, EMBASE, and Web of Science databases until June 2021 was conducted. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were determined using a random effects model. Results Ten studies involving 866 women with PCOS and 548 age- and body mass index-matched women without PCOS were included. The MPV was significantly increased in women with PCOS compared with non-PCOS women (SMD = 0.43, 95% CI = 0.13–0.72). Subgroup analyses showed that this trend was consistent in cross-sectional studies (SMD = 0.44, 95% CI = 0.03–0.86) and in Turkish women (SMD = 0.46, 95% CI = 0.13–0.79). Meta-regression analysis revealed a marginally positive correlation between the MPV and the homoeostasis model assessment of insulin resistance in women with PCOS. The sensitivity analysis showed that the effect estimate was robust and stable, and publication bias was not evidenced in the pooled analysis. Conclusions This meta-analysis revealed that women with PCOS have a significantly increased MPV than women without PCOS, which is probably associated with insulin resistance. INPLASY registration number: INPLASY2021100021.

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