Publication:

A comparative study of insulin levels in lean versus obese polycystic ovarian syndrome patients

Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age group. PCOS has been frequently associated with insulin resistance and obesity. Although most of the cases with PCOS are obese or overweight, a significant proportion of patients have normal body mass index (BMI≤25 kg/m2) that makes diagnostic work up and therapeutic approach more difficult. These cases are referred to as “lean PCOS.”

Methods This hospital based prospective, comparative cross-sectional study was conducted to estimate the insulin levels and insulin resistance in lean versus over-weight or obese PCOS patients and to evaluate the correlation of BMI with clinical parameters, serum insulin levels, and hormone profile in these patients. Patients were grouped according to their BMI: Lean group-(n=46) BMI<25 kg/m2 and obese group-(n=40) BMI≥25 kg/m2.

Results Serum insulin levels in obese PCOS patients were significantly higher than in lean PCOS patients (p<0.001). Overweight or obese PCOS women achieved significantly higher HOMA-IR than lean PCOS patients (p<0.001). The difference in fasting blood sugar levels in lean versus obese PCOS patients were not significantly different. Comparisons of the two groups showed no statistical differences in gonadotrophins (LH and FSH) values and LH/FSH ratio. The serum testosterone level was significantly higher in the obese group compared with the lean group (p=0.043).

Conclusions We conclude that the overweight/obese PCOS patients had higher tendency to develop insulin resistance and elevated fasting insulin levels as compared to their lean counterparts. Thus, weight reduction and metformin therapy hold great potential in managing a patient with insulin resistance in PCOS but will not have much effect on hormonal profile of a patient with PCOS but will not have much effect on hormonal profile of a patient with PCOS.