Objectives: Hirsutism is a common clinical condition in women during reproductive age and characterized by excessive growth of terminal hair in the androgen-sensitive skin regions. Polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH) account for most of the cases of hirsutism. Insulin resistance and hyperinsulinemia have been demonstrated in women with PCOS and IH. We intended to investigate the degree of insulin resistance in women with PCOS compared to weight-matched women with IH.
Methods: Thirty women with PCOS (mean age, 31.2±3.7 years; body mass index (BMI), 23.3±2.1 kg/m2) and 38 women with IH (mean age, 25.0±5.1 years; BMI, 24.9±3.4 kg/m2) were included in the study. The presence of insulin resistance was investigated by using basal insulin levels, the oral glucose tolerance test, and the homeostasis model assessment (HOMA) score in both groups. Written informed consent was obtained after the procedure had been fully explained.
Results: Patients with PCOS had significantly (P<0.05) higher basal insulin levels (26.9±6.1 vs 10.8±6.5 mU/l), HOMA scores (6.3±1.3 vs 2.3±1.7) and FBS (95.4±8.2 vs 82.4±8.9 mg/dl) than patients with IH. Twenty-seven normal-weighted patients (90%) with PCOS and 10 (26.3%) normal-weighted women with IH had HOMA scores of greater than 2.5. Six patients (20%) with PCOS and 2 women with IH (5.3%) had impaired glucose tolerance.
Conclusion: PCOS and IH are associated with insulin resistance independent of total body mass. In women with PCOS, insulin resistance appears more common in both obese and non-obese women compared to women with IH. Hyperinsulinemia appears to play a key pathogenic role in the ovarian androgen overproduction, because of the stimulatory effect of insulin on ovarian steroid production.
03 - 07 May 2008
European Society of Endocrinology