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2019, Number 2

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Rev Cuba Endoc 2019; 30 (2)

Insulin resistance in women with polycystic ovary syndrome

Monteagudo PG, González SR, Gómez AM, Ovies CG, Menocal AA, Rodríguez MK, Puentes CJ, Bell HYM

Language: Spanish
References: 57
Page: 1-22
PDF size: 649.98 Kb.


ABSTRACT

Introduction: Insulin resistance is common in polycystic ovary syndrome, with differences between phenotypes and discrepancies on how to measure it.
Objective: To identify disorders of insulin sensitivity and resistance in women with polycystic ovarian syndrome and determine if the latter is greater in the classic phenotype.
Methods: The study included 152 women. 45 of them had no polycystic ovary syndrome (Group I), 46 had clinical polycystic ovary syndrome (Group II) and 61 had classic polycystic ovary syndrome (Group III). Oral glucose tolerance test was performed, fasting insulin sensitivity or resistance indices (HOMA-IR, I0/G0, FIRI, ISI, Belfiore, Bennet, Quicki, Raynaud) were calculated and the tolerance test to oral glucose (Belfiore2, Ribel, Ins2glu2, ATI, IITotal, DATI/DATG, Matsuda, BetaHOMA) was also assessed. Kruskal-Wallis, Mann-Whitney and Chi square tests were used.
Results: Women with polycystic ovarian syndrome had more global and central obesity (p < 0.05), more blood glucose level at 30, 120 and 180 minutes of the oral glucose tolerance test (p <0.05 ) and insulinemia at 30, 60 and 120 (p < 0.0001), which was higher in group III. Fasting intolerance was diagnosed in one woman in each group and altered tolerance in one of group II and group III, respectively. There were no significant differences between groups for fasting insulin sensitivity or resistance indices, nor for HOMA among normal weight women vs. overweight-obesity (p> 0.05). The median indexes of the oral glucose tolerance test were lower for those of sensitivity (Belfiore2, Ribel) and higher for those of insulin resistance (Ins2glu2, ATI, IITotal) in Group III. The DATI/DATG, Matsuda and BetaHOMA had no significant differences.
Conclusions: Women with polycystic ovarian syndrome have higher glycemic response, insulin resistance and post-overload glucose hyperinsulinism than women with normal ovarian function, which is more evident in the classical phenotype. Fasting rates are less sensitive, regardless of body weight. Tests such as insulinemia 60 minutes after the oral glucose tolerance, Belfiore 2, ATI and IITotal are most useful.


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