A prospective study of insulin resistance among infertile women with polycystic ovarian syndrome

M. Smitha; S. Jyothi; Anand Acharya

doi:10.18203/2320-1770.ijrcog20183795

Authors

M. Smitha Department of Obstetrics and Gynecology, Konaseema Institute of Medical Science Amalapuram, Andra Pradesh, India
S. Jyothi Department of Obstetrics and Gynecology, Konaseema Institute of Medical Science Amalapuram, Andra Pradesh, India
Anand Acharya Department of Obstetrics and Gynecology, Konaseema Institute of Medical Science Amalapuram, Andra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20183795

Keywords:

Insulin resistance, Infertility, Polycystic ovarian disease

Abstract

Background: Insulin plays a key role in producing hyperandronism and suppression of insulin secretion in women with PCOS is associated with decreased cytochrome P450c17α. cytochrome P450c17α is a bifunctional enzyme present in ovary is a key enzyme for androgen synthesis. Various studies have been conducted regarding association of insulin resistance with PCOS in infertile patients but there is no study is available about this in our area. So we have designed this study to evaluate insulin resistance in infertile patients with PCOS in rural Andhra Pradesh.

Methods: The study population include 180 untreated patients who attended the infertility clinic in outpatient department of obstetrics with infertility due to different cause that include polycystic ovarian disorder also. They have been selected for this study randomly based on inclusion and exclusion criteria.

Results: The mean value of glucose insulin ratio was 5.146+2.611 in group A and 8.62 + 5.55 in group B the P value was 0.004909. The mean of LH/FSH ratio was 1.78+0.423 in group A and 1.02 +0.042 in group B. The P value was <0.00001. The mean of HOMA IR was 8.375+ 2.68 in group A and 3.03+ 1.09 in group B, with P value <0.00001. The mean value of QUICKI was 0.2815+ 0.0002875 in group A and 0.347+0.10 in group B with P value <0.00001. Mean serum DHEAS level was 275.59 + 53.48 in infertile patient with PCOS and 208.48 + 36.11 in infertile patients without PCOS. The p value was 0.00012.

Conclusions: Based on present study we would like to conclude that the body mass index was high among infertile women with PCOS and a greater number of women presented with acanthosis. There was decrease insulin sensitivity and increase insulin resistance among infertile women with poly cystic ovarian disease, in rural area of Andhra Pradesh and that is not different from the study of other part of world.

Metrics

Metrics Loading ...

References

bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-91.

Madani T, Hosseini R, Ramezanali F, Khalili G, Jahangiri N, Ahmadi J, et al. Metabolic syndrome in infertile women with polycystic ovarian syndrome. Arch Endocrinol Metabol. 2016;60(3):199-204.

Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on womens health aspects of polycystic ovary syndrome (PCOS). Human Reprod. 2012;27(1):14-24.

Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clinical Endocrinol Metabol. 1980;50(1):113-6.

Al-Jefout M, Alnawaiseh N, Al-Qtaitat A. Insulin resistance and obesity among infertile women with different polycystic ovary syndrome phenotypes. Scientific Rep. 2017;7(1):5339.

Ibrahim A, Abdelazima W, Farok E., Metabolic syndrome among infertile women with polycystic ovary syndrome Asian Pacific J Reprod. 2015;4(1):44-8.

Nestler JE, Jakubowicz DJ. Decreases in ovarian cytochrome P450c17 alpha activity and serum free testosterone after reduction of insulin secretion in polycystic ovary syndrome. N Engl J Med. 1996;335(9):617-23.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004 Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.

Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clinical Endocrinol Metabol. 2000;85(7):2402-10.

Haq F, Aftab O, Rizvi J, Clinical, biochemical and ultrasonographic features of infertile women with polycystic ovarian syndrome. JCPSP. 2007;17(2):76-80.

Mandrelle K, Kamath MS, Bondu DJ, Chandy A, Aleyamma TK, George K. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic in a tertiary care hospital in south India. J Human Reprod Sci. 2012;5(1):26.

Havagiray RC, Eman AA, Anfal MA, Buthina MAB, Zamzam KA, Maisa MAT, et al Insulin Sensitivity and Resistance in Infertile Women with Polycystic Ovary Syndrome. J Gynecol Women’s Health. 2017;6(5):555700.

Svendsen PF, Nilas L, Nørgaard K, Jensen JE, Madsbad S. Obesity, body composition and metabolic disturbances in polycystic ovary syndrome. Hum Reprod. 2008;3(9):2113-21.

Stovall DW, Bailey AP, Pastore LM. Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome. J Womens Health (Larchmt). 2011;20(1):37-43.

Kauffman RP, Baker VM, DiMarino P, Gimpel T, Castracane VD. Polycystic ovarian syndrome and insulin resistance in white and Mexican American women: a comparison of two distinct populations. American J Obstetrics Gynecol. 2002;187(5):1362-9.

Wilma DS, Kavya N, Kulkarni S. Evaluation of insulin sensitivity status in polycystic ovarian syndrome. Asian Pacific J Trop Dis. 2011;1(1):67-70.

Banaszewska B, Spaczynski RZ, Pelesz M, Pawelczyk L. Incidence of elevated LH/FSH ratio in polycystic ovary syndrome women with normo-and hyperinsulinemia. Rocz Akad Med Bialymst. 2003;48(1):131-4.

Khanam K, Parvin M. An Observational Study on 100 Patients with Polycystic Ovarian Syndrome (PCOS). J Enam Med College. 2014 Jan 1;4(3):156-60.

Brennan K, Huang A, Azziz R. Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome. Fertil Steril. 2009;91(5):1848-52.