Endocrine Abstracts (2009) 20 P490

Insulin-resistance and abnormal glycaemia characterize the metabolic syndrome of polycystic ovary syndrome but not of matched controls

Serban Radian1,2, Valentina Raluca Mihaila1, Ileana Botusan1, Nicoleta Baculescu1, Monica Gheorghiu1,2, Simona Fica1, Florin Grigorescu3 & Mihail Coculescu1,2

1C Davila University of Medicine, Bucharest, Romania; 2Institute of Endocrinology, Bucharest, Romania; 3Molecular Endocrinology Laboratory, IURC, Montpellier 1 University, Montpellier, France.

Background: The incidence of metabolic syndrome (MetS) is higher in polycystic ovary syndrome (PCOS) patients than in the general population. However, it is still unclear if MetS is qualitatively different in PCOS.

Aim: To compare the distribution of MetS diagnostic criteria and of insulin-resistance in subjects with MetS (PCOS versus matched controls).

Patients: Of 97 patients with PCOS (Rotterdam criteria) and 31 age- and BMI-matched eumenorrheic, non-hirsute women were recruited at the Institute of Endocrinology, Bucharest, Romania. All subjects were examined and waist circumference, BMI and blood pressure (BP) were recorded. Blood lipids, glycemia and insulinemia were measured after an overnight fast and a standard oral glucose tolerance test (OGTT) was performed. All samples were collected during the early follicular phase of the menstrual cycle.

Results: According to IDF criteria, MetS was present in 33% of PCOS patients and in 29% of controls (P=NS). No significant differences were found between the PCOS patients with MetS (group A, n=32) and controls with MetS (group B, n=9), regarding serum triglycerides, HDL-cholesterol, BP values and waist circumference. Impaired fasting glucose (IFG) or type 2 DM was more frequent in group A than group B (40.63% versus none, P<0.05).

Insulin-resistance (HOMA-IR> 90th percentile of a Romanian female population reference) was more frequent in group A than group B (55.17 vs 12.5%, P=0.04). Insulin-resistance was strongly associated with MetS (P<0.0001, χ2) within the whole PCOS group, but not in the control subjects. Furthermore, PCOS patients with MetS had higher 2hr-glucose during OGTT than patients without MetS (125.2±6 vs 97.8±4.1 mg/dl, P<0.001; mean±S.E.M).

Conclusions: The incidence of each MetS criterion is not different between MetS subjects with PCOS and matched MetS controls, except for IFG / type 2 DM. In PCOS, insulin-resistance is more frequent and correlates strongly with MetS.

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