Method identifies parameters for insulin resistance testing in PCOS

Insulin values peaked at 30 minutes after an oral glucose tolerance test in lean Chinese women with polycystic ovary syndrome, whereas insulin values peaked at 60 minutes among women with obesity and polycystic ovary syndrome, according to study findings.

“With investigation of the etiology, insulin resistance is regarded as a key factor in the pathophysiology of polycystic ovary syndrome,” Hong Jie, MD, PhD, of the Shanghai Institute of Endocrine and Metabolic Diseases, and colleagues wrote. “In 2013, the OGTT was suggested by the American Endocrine Society for PCOS patients before pregnancy. However, there is little published information from China on insulin levels in PCOS.”

The researchers performed standard OGTTs on 426 patients with PCOS and 95 controls, conducting testing after a 10-hour fast. Jie and colleagues obtained patients’ plasma glucose and insulin levels at baseline and 30, 60, 120 and 180 minutes after testing. Researchers also evaluated lipid levels in each participant.

Nearly 24% of patients demonstrated abnormal glucose metabolism, the researchers reported. One-fifth (n = 89) showed glucose tolerance with impaired glucose regulation, whereas 2.82% (n = 12) had type 2 diabetes. Glucose and lipid levels gradually increased with increasing impairment in glucose metabolism (P < .05), Jie and colleagues wrote. Patients with impaired glucose regulation showed a greater insulin response than those with diabetes.

Patients with PCOS, both those who were lean and those with obesity, had a higher BMI, as well as higher insulin, lipid and serum glucose values, compared with controls, the researchers wrote. Lean patients’ insulin values peaked at 30 minutes after testing, whereas in patients with obesity, insulin values peaked at 60 minutes.

“Assessment of [insulin resistance] should not be ignored in lean individuals and should be emphasized in obese individuals,” Jie and colleagues wrote. “New assessment parameters were developed: HOMA-M30 for lean PCOS patients and HOMA-M60 for obese patients. A multicenter study will be required to test the HOMA-M30 in lean groups and HOMA-M60 in obese groups, using a larger sample size and other ethnic populations.” – by Andy Polhamus

Disclosures: The authors report no relevant financial disclosures.