Polycystic ovarian syndrome and insulin resistance: a South Indian study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20201054Keywords:
Hirsutism, Homeostatic model assessment - insulin resistance, Insulin resistance, Polycystic ovary syndromeAbstract
Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Some studies have characterized different aspects of women presenting with PCOS. In this study we characterise the association of insulin resistance (IR) in patients with PCOS in the southern Indian state of Andhra Pradesh.
Methods: A total of 50 women diagnosed to have PCOS according to Rotterdam criteria were studied. IR was estimated using Homeostatic model assessment - insulin resistance (HOMA-IR) and clinical characteristics were recorded.
Results: The prevalence of IR among the study population was 36%. All PCOS patients with IR were overweight or obese, and had impaired glycaemic status, 75% of PCOS patients with IR also had features of hirsutism.
Conclusions: Considering the prevalence of IR, obesity and impaired fasting glucose in women with PCOS, early institution of treatment by lifestyle changes or medication would lead to improvement in reproductive and metabolic abnormalities.
References
Bharathi RV, Swetha S, Neerajaa J, Madhavica JV, Janani DM, Rekha SN, et al. An epidemiological survey: effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertil Soc J. 2017;22:313-6.
Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab. 1980;50:113-6.
Kovacs G, Smith J. A guide to the polycystic ovary: Its effects on health and fertility. Castle Hill Barns, UK: TFM Publishing. 2002.
Carey AH, Chan KL, Short F, White DM, Williamson R, Franks S. Evidence for a single gene effect in polycystic ovaries and male pattern baldness. Clin Endocrinol (Oxf). 1993;38:653-8.
Dunaif A, Xia J, Book C, Schenker E, Tang Z. Excessive insulin receptor serine phosphorylation in cultured fibroblasts and in skeletal muscle: a potential mechanism for insulin resistance in the polycystic ovary syndrome. J Clin Invest. 1995;96:801-10.
Zhang L, Rodriquez H, Ohno S, Miller WL. Serine phosphorylation of human P450c17 increases 17,20 lyase activity: implications for adrenarche and the polycystic ovary syndrome. Proc Natl Acad Sci USA. 1995;92:10619-23.
Burke JP, Hale DE, Hazuda HP, Stern MP. A quantitative scale of acanthosis nigricans. Diabetes Care. 1999;22:1655-9.
Marshall JC, Dunaif A. All women with PCOS should be treated for insulin resistance. Fertil Steril. 2012;97(1):18-22.
Jovanovic VP, Carmina E, Lobo RA. Not all women diagnosed with PCOS share the same cardiovascular risk profiles. Fertil Steril. 2010;94:826-32.
Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Update. 2009;15:477-88.
Kierland RR, Lakatos I, Szijarto L. Acanthosis nigricans: an analysis of data in twenty-two cases and a study of its frequency in necropsy material. J Invest Dermatol. 1947;9:299-305.
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetol. 2001;44:1094-101.
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;84:165-9.
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;22:141-6.
Ehrmann DA, Kasza K, Azziz R, Legro RS, Ghazzi MN. For the PCOS/Troglitazone study group. Effects of race and family history of type 2 diabetes on metabolic status of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:66-71.
Luque-Ramírez M, Alpanes M, Escobar-Morreale HF. The determinants of insulin sensitivity, B-cell function, and glucose tolerance are different in patients with polycystic ovary syndrome and in women who do not have hyperandrogenism. Fertil Steril. 2010;94:2214-21.
Norman RJ, Davies MJ, Lord J, Moran LJ. The life style modification in polycystic ovary syndrome. Trends Endocrinol Metab. 2002;13:251-7.
Hoeger KM. Exercise therapy in polycystic ovary syndrome. Semin Reprod Med. 2008;26:93-100.