Insulin resistance in obese and lean women with polycystic ovarian syndrome


  • Jayashree S. Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
  • Shylaja P. Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
  • Virupakshi Ajjammanavar Department of Obstetrics and Gynecology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India



Fasting Insulin, HOMA-IR, Lean PCOS, Obese PCOS


Background: According to NIH criteria for PCOS, the estimated prevalence of this disorder has been reported to range from 4% to 10% of women in their reproductive years, which designates PCOS as the most common endocrinopathy of women. Insulin resistance is common in PCOS and obesity contributes an additional component to insulin resistance in obese PCOS.

Methods: The study was a prospective study. One-hundred and twenty PCOS women were divided into two groups: Group O - obese (n = 60) and Group L - lean (body mass index [BMI] cutoff <23 kg/m2). Oral glucose tolerance test, serum fasting insulin and HOMA- IR were compared between these groups.

Results: Impaired glucose tolerance was seen in 33.3 % of lean PCOS and 36.7% of obese PCOS women. 5% of lean PCOS and 10% of obese PCOS women had hyperinsulinemia. 38.3% of lean PCOS and 51.7% of obese PCOS women had insulin resistance. But the differences were not statistically significant. However, HOMA-IR and fasting insulin values showed a significant positive correlation with BMI.

Conclusions: Both obese and lean women with PCOS are vulnerable to the problems of insulin resistance irrespective of BMI and insulin resistance shows a positive correlation with BMI.


Bereck JS. Endocrine Disorders. In: Bereck JS, editor. Bereck and Novak’s Gynecology. 15th ed. New Delhi: Wolters Kluwer Health (India )Pvt Ltd-Lippincott Williams and Wilkins; 2012. p. 1066–99.

Krithika D Muralidhara, Prabha M Adhikari, Muralidhara D V. Overweight/Obesity and metabolic syndrome in women with polycystic ovary syndrome. Indian J Basic App Med Res. 2015;4(3):227-36.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod Oxf Engl. 2004;19(1):41-7.

Archard C, Thiers J. Le virilisme pilaire et son association l’ insuffisance glycolytique(diabetes a femmes de barbe). Bull Acad Natl Med(Paris). 1921;(86):51-64.

Yildizhan B, Anik Ilhan G, Pekin T. The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome. J Obstet Gynaecol J Inst Obstet Gynaecol. 2016;36(7):893-6.

Livadas S, Diamanti-Kandarakis E. Polycystic ovary syndrome: definitions, phenotypes and diagnostic approach. Front Horm Res. 2013;40:1-21.

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

Hughesdon PE. Morphology and morphogenesis of the Stein-Leventhal ovary and of so-called ‘hyperthecosis’. Obstet Gynecol Surv. 1982;37(2):59-77.

Akshaya S, Bhattacharya ratnaboli. Comparitive study of clinical profile of lean and obese polycystic ovary syndrome women. Int J Reprod Contracept Obstet Gynecol.2017;5(8):2530-3.

Gupta N, Radhakrishnan G, S V M, A G R. Comparison of metabolic and endocrinal parameters in obese and nonobese women of polycystic ovarian syndrome with normal controls. Fertil Sci Res. 2015;2(1):19.

Gambineri A, Pelusi C, Manicardi E, Vicennati V, Cacciari M, Morselli-Labate AM, et al. Glucose intolerance in a large cohort of mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Diab. 2004;53(9):2353-8.

Snehalatha C, Ramchandran A, Kapur A, Vijay V. Age-specific prevalence and risk associations for impaired glucose tolerance in urban southern Indian population. J Assoc Physicians India. 2003;51:766-9.

Majumdar A, Singh TA. Comparison of clinical features and health manifestations in lean vs. obese Indian women with polycystic ovarian syndrome. J Hum Reprod Sci. 2009;2(1):12-7.

Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84(1):165-9.

Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22(1):141-6.

Elting MW, Korsen TJ, Bezemer PD, Schoemaker J. Prevalence of diabetes mellitus, hypertension and cardiac complaints in a follow-up study of a Dutch PCOS population. Hum Reprod Oxf Engl. 2001;16(3):556-60.

Yildirim B, Sabir N, Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2003;79(6):1358-64.

Silfen ME, Denburg MR, Manibo AM, Lobo RA, Jaffe R, Ferin M, et al. Early endocrine, metabolic, and sonographic characteristics of polycystic ovary syndrome (PCOS): comparison between nonobese and obese adolescents. J Clin Endocrinol Metab. 2003;88(10):4682-8.

Morales AJ, Laughlin GA, Bützow T, Maheshwari H, Baumann G, Yen SS. Insulin, somatotropic, and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome: common and distinct features. J Clin Endocrinol Metab. 1996;81(8):2854-64.

Vrbíková J, Vondra K, Cibula D, Dvoráková K, Stanická S, Srámková D, et al. Metabolic syndrome in young Czech women with polycystic ovary syndrome. Hum Reprod Oxf Engl. 2005;20(12):3328-32.

Ramezani Tehrani F, Montazeri SA, Hosseinpanah F, Cheraghi L, Erfani H, Tohidi M, et al. Trend of Cardio-Metabolic Risk Factors in Polycystic Ovary Syndrome: A Population-Based Prospective Cohort Study. PloS One. 2015;10(9):e0137609.






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