Limitations of insulin resistance assessment in polycystic ovary syndrome
Background: Though insulin resistance (IR) is common in polycystic ovary syndrome (PCOS), there is no agreement as to what surrogate method of assessment of IR is most reliable. Subjects and methods: In 478 women with PCOS, we compared methods based on fasting insulin and either fasting glucose (HO...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-03-01
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| Series: | Endocrine Connections |
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| Online Access: | http://www.endocrineconnections.com/content/7/3/403.full |
| _version_ | 1818499942222659584 |
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| author | Krzysztof C Lewandowski Justyna Płusajska Wojciech Horzelski Ewa Bieniek Andrzej Lewin´ski |
| author_facet | Krzysztof C Lewandowski Justyna Płusajska Wojciech Horzelski Ewa Bieniek Andrzej Lewin´ski |
| author_sort | Krzysztof C Lewandowski |
| collection | DOAJ |
| description | Background: Though insulin resistance (IR) is common in polycystic ovary syndrome (PCOS), there is no agreement as to what surrogate method of assessment of IR is most reliable.
Subjects and methods: In 478 women with PCOS, we compared methods based on fasting insulin and either fasting glucose (HOMA-IR and QUICKI) or triglycerides (McAuley Index) with IR indices derived from glucose and insulin during OGTT (Belfiore, Matsuda and Stumvoll indices).
Results: There was a strong correlation between IR indices derived from fasting values HOMA-IR/QUICKI, r = −0.999, HOMA-IR/McAuley index, r = −0.849 and between all OGTT-derived IR indices (e.g. r = −0.876, for IRI/Matsuda, r = −0.808, for IRI/Stumvoll, and r = 0.947, for Matsuda/Stumvoll index, P < 0.001 for all), contrasting with a significant (P < 0.001), but highly variable correlation between IR indices derived from fasting vs OGTT-derived variables, ranging from r = −0.881 (HOMA-IR/Matsuda), through r = 0.58, or r = −0.58 (IRI/HOMA-IR, IRI/QUICKI, respectively) to r = 0.41 (QUICKI/Stumvoll), and r = 0.386 for QUICKI/Matsuda indices. Detailed comparison between HOMA-IR and IRI revealed that concordance between HOMA and IRI was poor for HOMA-IR/IRI values above 75th and 90th percentile. For instance, only 53% (70/132) women with HOMA-IR >75th percentile had IRI value also above 75th percentile. There was a significant, but weak correlation of all IR indices with testosterone concentrations.
Conclusions: Significant number of women with PCOS can be classified as being either insulin sensitive or insulin resistant depending on the method applied, as correlation between various IR indices is highly variable. Clinical application of surrogate indices for assessment of IR in PCOS must be therefore viewed with an extreme caution. |
| first_indexed | 2024-12-10T20:36:25Z |
| format | Article |
| id | doaj.art-785a90558008449ba5d622ed63af5a9a |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-12-10T20:36:25Z |
| publishDate | 2018-03-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-785a90558008449ba5d622ed63af5a9a2022-12-22T01:34:31ZengBioscientificaEndocrine Connections2049-36142049-36142018-03-017311010.1530/EC-18-0021Limitations of insulin resistance assessment in polycystic ovary syndromeKrzysztof C Lewandowski0Justyna Płusajska1Wojciech Horzelski2Ewa Bieniek3Andrzej Lewin´ski4Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland; Polish Mother’s Memorial Hospital–Research Institute, Lodz, PolandPolish Mother’s Memorial Hospital–Research Institute, Lodz, PolandFaculty of Mathematics and Computer Science, University of Lodz, Lodz, PolandPolish Mother’s Memorial Hospital–Research Institute, Lodz, PolandDepartment of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland; Polish Mother’s Memorial Hospital–Research Institute, Lodz, PolandBackground: Though insulin resistance (IR) is common in polycystic ovary syndrome (PCOS), there is no agreement as to what surrogate method of assessment of IR is most reliable. Subjects and methods: In 478 women with PCOS, we compared methods based on fasting insulin and either fasting glucose (HOMA-IR and QUICKI) or triglycerides (McAuley Index) with IR indices derived from glucose and insulin during OGTT (Belfiore, Matsuda and Stumvoll indices). Results: There was a strong correlation between IR indices derived from fasting values HOMA-IR/QUICKI, r = −0.999, HOMA-IR/McAuley index, r = −0.849 and between all OGTT-derived IR indices (e.g. r = −0.876, for IRI/Matsuda, r = −0.808, for IRI/Stumvoll, and r = 0.947, for Matsuda/Stumvoll index, P < 0.001 for all), contrasting with a significant (P < 0.001), but highly variable correlation between IR indices derived from fasting vs OGTT-derived variables, ranging from r = −0.881 (HOMA-IR/Matsuda), through r = 0.58, or r = −0.58 (IRI/HOMA-IR, IRI/QUICKI, respectively) to r = 0.41 (QUICKI/Stumvoll), and r = 0.386 for QUICKI/Matsuda indices. Detailed comparison between HOMA-IR and IRI revealed that concordance between HOMA and IRI was poor for HOMA-IR/IRI values above 75th and 90th percentile. For instance, only 53% (70/132) women with HOMA-IR >75th percentile had IRI value also above 75th percentile. There was a significant, but weak correlation of all IR indices with testosterone concentrations. Conclusions: Significant number of women with PCOS can be classified as being either insulin sensitive or insulin resistant depending on the method applied, as correlation between various IR indices is highly variable. Clinical application of surrogate indices for assessment of IR in PCOS must be therefore viewed with an extreme caution.http://www.endocrineconnections.com/content/7/3/403.fullpolycystic ovary syndromeinsulin resistanceBelfiore indexMatsuda indexStumvoll indexMcAuley indexHOMAQUICKI |
| spellingShingle | Krzysztof C Lewandowski Justyna Płusajska Wojciech Horzelski Ewa Bieniek Andrzej Lewin´ski Limitations of insulin resistance assessment in polycystic ovary syndrome Endocrine Connections polycystic ovary syndrome insulin resistance Belfiore index Matsuda index Stumvoll index McAuley index HOMA QUICKI |
| title | Limitations of insulin resistance assessment in polycystic ovary syndrome |
| title_full | Limitations of insulin resistance assessment in polycystic ovary syndrome |
| title_fullStr | Limitations of insulin resistance assessment in polycystic ovary syndrome |
| title_full_unstemmed | Limitations of insulin resistance assessment in polycystic ovary syndrome |
| title_short | Limitations of insulin resistance assessment in polycystic ovary syndrome |
| title_sort | limitations of insulin resistance assessment in polycystic ovary syndrome |
| topic | polycystic ovary syndrome insulin resistance Belfiore index Matsuda index Stumvoll index McAuley index HOMA QUICKI |
| url | http://www.endocrineconnections.com/content/7/3/403.full |
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