Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, affecting approximately 5% to 8% of premenopausal women. Insulin resistance is believed to be a key pathophysiologic factor and increases the risk of associated metabolic syndrome (MetSyn) and diabetes. We looked at the presence of insulin resistance in young women with PCOS from South India. The data is derived from a larger study of polycystic amenorrheic women looking at endothelial progenitor cell response to a glucose challenge.

Methods: The study population included 39 women with anovulatory cycles and polycystic ovaries on USG. The control group were 20 age and BMI matched healthy volunteers, with normal menstrual cycles. Fasting and postprandial glycemic, lipid, insulin and hormonal measurements were compared between the two groups. Categorical variables and proportion estimates were evaluated for statistically significant difference (P < 0.05) using student’s t-test and chi-square test as appropriate. Results As defined by the NCEP ATP III criteria, 41% (15 out of 36) of the young PCOS women (average age 22.5±4.7 years) had metabolic syndrome compared to none (0 out of 20) in the control group (average age 22.2±3.7 years). Both the groups were matched with respect to BMI, and waist hip ratio. Only the mean waist circumference was significantly higher ((96.6 ± 12.8 cms versus 90 ± 9.9 cms, P = 0.04840) in the PCOS women compared to control population. Both insulin resistance and insulin secretion parameters were significantly higher in the euglycemic PCOS as compared to the control group. The insulin resistance was estimated by the HOMA IR (2.94 ± 2.01 in PCOS vs 1.65 ± 0.58 in the control, P value 0.0005) and insulin secretion by the HOMA-β values (150.2 ± 56.86 in PCOS vs 110.9 ± 29.9 in control group, P value 0-001). The strongest predictor of the presence of metabolic syndrome was the waist circumference (r value 0.64), followed by the HOMA IR (r value 0.66). Conclusions In this study, the prevalence of MetSyn was significantly higher in young women with PCOS compared to control group. Waist circumference and HOMA IR are strong predictors of MetSyn. MetSyn is also associated with a higher HOMA-β value in the PCOS women. The high prevalence of insulin resistance and MetSyn drives home the need to screen more aggressively for the metabolic syndrome and insulin resistance in young women with PCOS.