Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment.
Level 4 - case-series / case-control
Prospective case-control study
PubMed 15866584 · doi:10.1016/j.fertnstert.2004.11.070
What was done
A prospective case-control study at a single university medical center evaluated 271 women with polycystic ovary syndrome (PCOS) and 260 eumenorrheic, non-hirsute control women. Fasting blood samples were analyzed for total testosterone, free testosterone, DHEAS, sex hormone-binding globulin, fasting glucose, and fasting insulin. Insulin resistance (IR) and beta-cell function were calculated using the homeostasis model assessment (HOMA-IR and HOMA-%beta-cell) and adjusted for age, body mass index (BMI), and race.
What was found
Patients with PCOS and controls differed significantly in all measured hormonal and metabolic parameters except fasting glucose. After adjusting for race, age, and BMI, 64.4% of PCOS patients had insulin resistance and 2.6% had beta-cell dysfunction. Compared with PCOS patients without IR (n = 96), those with IR (n = 174) were more obese and exhibited higher beta-cell function.
Why it matters
This study provides an adjusted estimate showing that although insulin resistance affects roughly two-thirds of PCOS patients and tracks with obesity, it is not an obligatory or universal feature of the syndrome.
Limits
Insulin resistance was estimated via fasting-derived HOMA indices rather than the gold-standard hyperinsulinemic-euglycemic clamp. The abstract omits numerical baseline biochemical values, exact p-values, and confidence intervals. The single-center sample may limit broader generalizability.
Cited by
- partial Eighty percent of women with polycystic ovary syndrome (PCOS) have insulin resistance.