Publication:

Comparison of mathematical indices of insulin resistance for clinical application in the four phenotypes of polycystic ovarian syndrome

Background Insulin resistance may not be essential for the diagnosis, but does play a crucial role in PCOS and contributes to significant morbidity and long term life threatening sequelae. The extent of this resistance differs in different phenotypes and is difficult to assess in clinical settings. In this study we used mathematical indices to assess insulin resistance across the whole PCOS spectrum and used cut off values to find whether all PCOS phenotypes were Insulin resistant.

Methods 60 newly diagnosed PCOS participants were included in the study analysis. Depending upon their presentation these participants were grouped into 4 phenotypes. The two mathematical indices HOMA and QUICKI were calculated for each participant .The mean value of HOMA and QUICKI were calculated for each group and compared using ANOVA. A cut off value of >2.6 for HOMA and <0.33 for QUICKI was used to determine Insulin resistance.

Results There was a significant difference in the degree of insulin resistance among the different phenotypes of PCOS. Not all PCOS women can be called insulin resistant when using certain cut off values for QUICKI and HOMA. The PCOM+MI+HA phenotype appears to be more resistant than all other phenotypes.

Conclusions Insulin resistance is a not present universally and varies among all phenotypes of PCOS. In clinical setting simple mathematical indices could be used to identify these individuals and initiate appropriate therapy in order to prevent long term metabolic sequelae. Cut off values for both the indices need to take into account all factors that influence insulin sensitivity.