Correlation of ovarian and stromal volume to fasting and postprandial insulin levels in polycystic ovarian syndrome patients
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20222792Keywords:
Infertility, Insulin resistance, Ovarian volume, PCOSAbstract
Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder with incidence of 5-10% in the reproductive-aged female population. With 3D ultrasound, we can precisely evaluate the ovarian anatomy. Hyperinsulinemia produces hyperandrogenism which in turn causes increased stromal production, increasing stromal volume and ovarian volume. This study aimed to find out if this ovarian and stromal volume increase, has any correlation with insulin levels.
Methods: The study was an observational study conducted in Sri Ramachandra College and Hospital, Chennai. This study comprised 100 patients in their reproductive age group with PCOS. After informed consent patients diagnosed with PCOS were asked to come on day 3 of cycle. On day 3 of cycle, fasting and 2 hours (75 gm glucose) postprandial insulin levels were measured. Ovarian and stromal volume using 3D ultrasound was measured on the same day. Results were then analysed for correlation.
Results: A total of 100 patients were involved in the study. Mean age group was 25 years. The mean fasting and postprandial insulins of the women in the study were 20.19 mIU/l and 48.73 m IU/l respectively. The mean ovarian and stromal volume was 12.48 cm3 and 7.34 cm3 respectively. 2 tailed Pearson correlation was obtained and was found that stromal volume had a positive correlation with fasting and postprandial insulin levels but not ovarian volume.
Conclusions: Stromal volume alone rather than total ovarian volume had a strong correlation with fasting and postprandial insulin levels in polycystic ovarian syndrome patients.
References
Balen AH, Conway GS, Kaltas G, Techatrasak K, Manning PJ, West C, et al. Polycystic ovary syndrome: the spectrum of the dis-order in 1741 patients. Hum Reprod. 1995;10:2107-11.Sikka P, Gainder S, Dhaliwal LK, Bagga R, Sialy R, Sahdev S. Ultrasonography of the ovaries and its correlation with clinical and endocrine parameters in infertile women with PCOS. Int J Fertil Womens Med. 2007;52:41-7.
Panchal S, Nagori CB. Correlation of ovarian and stromal volumes to fasting and postprandial insulin levels in polycystic ovarian syndrome patients. Int J Infertil Fet Med. 2014;5(1):12-4.
Neoklis AG, Anastasia KA, Damianaki K, Nikolaos DR, Markantes G, Papadopoulos V, et al. Polycystic ovarian morphology is associated with hyperandrogenemia and insulin resistance in women with polycystic ovary syndrome (PCOS). J Steroids Horm Sci. 2016;7(1):1-5.
Markussis V, Goni MH, Tolis G. The role of insulin in ovarian size in patients with the polycystic ovary syndrome. Gynecol Endocrinol. 1994;8(3):197-202.
Christ JP, Brink HV, Brooks ED, Pierson RA, Chizen DR, Lujan ME. Ultrasound features of polycystic ovaries relate to degree of reproductive and metabolic disturbance in polycystic ovary syndrome. Fertil Steril. 2015;103(3):787-94.
Saxena P, Prakash A, Nigam A. Efficacy of 2-hour post glucose insulin levels in predicting insulin resistance in polycystic ovarian syndrome with infertility. J Hum Reprod Sci. 2011;4:20-2.
Wijeyaratne CN, Balen AH, Barth JH, Belchetz PE. Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference? Clin Endocrinol (Oxf). 2002;57:343-50.
Nardo LG, Buckett WM, Khullar V. Determination of the best-fitting ultrasound formulaic method for ovarian volume measurement in women with polycystic ovary syndrome. Fertil Steril. 2003;79:632-3.
Kyei-Mensah A, Maconochie N, Zaidi J, Pittrof R, Campbell S, Tan SL. Transvaginal three-dimensional ultrasound: reproducibility of ovarian and endometrial volume measurements. Fertil Steril. 1996;66:718-22.
Fulghesu AM, Ciampelli M, Belosi C, Apa R, Pavone V, Lanzone A. A new ultrasound criterion for the diagnosis of polycystic ovary syndrome: the ovarian stroma/total area ratio. Fertil Steril. 2001;76:326-331.
Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370:685-97.
Begum F. Clinical and hormonal profile of polycystic ovary syndrome. J SAFOG. 2009;1(2):22-5.
Nada Z. (2015). Which is more reliable in polycystic ovarian syndrome: body mass index or waist hip ratio? Int J Sci Basic Appl Res. 2015;24(2):283-90.
