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Reproductive Biomedicine
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Volume 19, Issue 7 (July 2021)
IJRM 2021, 19(7): 653-662 |
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Namavar Jahromi B, Borzou N, Parsanezhad M E, Anvar Z, Ghaemmaghami P, Sabetian S. Associations of insulin resistance, sex hormone-binding globulin, triglyceride, and hormonal profiles in polycystic ovary syndrome: A cross-sectional study. IJRM 2021; 19 (7) :653-662
URL: http://ijrm.ir/article-1-1860-en.html
URL: http://ijrm.ir/article-1-1860-en.html
Bahia Namavar Jahromi1 
, Niloofar Borzou2 , Mohammad Ebrahim Parsanezhad1 , Zahra Anvar3 , Parvin Ghaemmaghami4 , Soudabeh Sabetian * 5
, Niloofar Borzou2 , Mohammad Ebrahim Parsanezhad1 , Zahra Anvar3 , Parvin Ghaemmaghami4 , Soudabeh Sabetian * 5
1- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
2- Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
3- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
4- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. , soudabehsabet@gmail.com
2- Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
3- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
4- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. , soudabehsabet@gmail.com
Abstract: (1457 Views)
Background: Insulin resistance (IR) occurs in 50-70% of women with polycystic ovary syndrome (PCOS) and can be applied as a pre-diabetic feature in PCOS.
Objective: In this study, indirect methods including fasting blood sugar (FBS), fasting insulin (FI), FBS/FI ratio, and quantitative insulin sensitivity check index (QUICKI) were compared with the homeostasis model assessment of insulin resistance (HOMA-IR) as a standard technique. The association of IR to sex hormone-binding globulin (SHBG) and several hormones was also analyzed.
Materials and Methods: This cross-sectional study was performed on 74 PCOS women. Sensitivity and specificity of each IR method was calculated based on HOMA-IR. Hormonal profiles of the patients were compared between the groups with defined normal and abnormal values of IR.
Results: Triglyceride levels had a positive association with FBS and HOMA-IR (p = 0.002 and p = 0.01, respectively) with a negative association to QUICKI and SHBG (p = 0.02 and p = 0.02, respectively). SHBG showed a significant negative association with FBS (p = 0.001). Dehydroepiandrosterone sulfate showed a positive association with FI (p = 0.002). Seven PCOS women showed abnormal SHBG levels (< 36 nmol/L) while expressed normal values of the rest of the studied variables. FI and QUICKI had the highest sensitivity while FBS/FI and QUICKI had the highest specificity when HOMA-IR was applied as a standard test.
Conclusion: SHBG and Triglyceride had a significant negative and positive association with IR, respectively. HOMA-IR followed by FI and QUICKI is the most sensitive test for the detection of IR. SHBG levels can be a helpful biomarker for the diagnosis of PCOS.
Objective: In this study, indirect methods including fasting blood sugar (FBS), fasting insulin (FI), FBS/FI ratio, and quantitative insulin sensitivity check index (QUICKI) were compared with the homeostasis model assessment of insulin resistance (HOMA-IR) as a standard technique. The association of IR to sex hormone-binding globulin (SHBG) and several hormones was also analyzed.
Materials and Methods: This cross-sectional study was performed on 74 PCOS women. Sensitivity and specificity of each IR method was calculated based on HOMA-IR. Hormonal profiles of the patients were compared between the groups with defined normal and abnormal values of IR.
Results: Triglyceride levels had a positive association with FBS and HOMA-IR (p = 0.002 and p = 0.01, respectively) with a negative association to QUICKI and SHBG (p = 0.02 and p = 0.02, respectively). SHBG showed a significant negative association with FBS (p = 0.001). Dehydroepiandrosterone sulfate showed a positive association with FI (p = 0.002). Seven PCOS women showed abnormal SHBG levels (< 36 nmol/L) while expressed normal values of the rest of the studied variables. FI and QUICKI had the highest sensitivity while FBS/FI and QUICKI had the highest specificity when HOMA-IR was applied as a standard test.
Conclusion: SHBG and Triglyceride had a significant negative and positive association with IR, respectively. HOMA-IR followed by FI and QUICKI is the most sensitive test for the detection of IR. SHBG levels can be a helpful biomarker for the diagnosis of PCOS.
Type of Study: Original Article |
Subject:
Reproductive Biology
References
1. ESHRE Capri Workshop Group. Health and fertility in World Health Organization group 2 anovulatory women. Hum Reprod Update 2012; 18: 586-599. [DOI:10.1093/humupd/dms019] [PMID]
2. Al-Jefout M, Alnawaiseh N, Al-Qtaitat A. Insulin resistance and obesity among infertile women with different polycystic ovary syndrome phenotypes. Sci Rep 2017; 7: 1-9. [DOI:10.1038/s41598-017-05717-y] [PMID] [PMCID]
3. Baptiste CG, Battista MC, Trottier A, Baillargeon JP. Insulin and hyperandrogenism in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2010; 122: 42-52. [DOI:10.1016/j.jsbmb.2009.12.010] [PMID] [PMCID]
4. Livadas S, Pappas C, Karachalios A, Marinakis E, Tolia N, Drakou M, et al. Prevalence and impact of hyperandrogenemia in 1,218 women with polycystic ovary syndrome. Endocrine 2014; 47: 631-638. [DOI:10.1007/s12020-014-0200-7] [PMID]
5. Deswal R, Yadav A, Dang AS. Sex hormone binding globulin-an important biomarker for predicting PCOS risk: A systematic review and meta-analysis. Syst Biol Reprod Med 2018; 64: 12-24. [DOI:10.1080/19396368.2017.1410591] [PMID]
6. Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013; 98: 4565-4592. [DOI:10.1210/jc.2013-2350] [PMID] [PMCID]
7. Veltman-Verhulst SM, Goverde AJ, van Haeften TW, Fauser BC. Fasting glucose measurement as a potential first step screening for glucose metabolism abnormalities in women with anovulatory polycystic ovary syndrome. Hum Reprod 2013; 28: 2228-2234. [DOI:10.1093/humrep/det226] [PMID]
8. Trout KK, Homko C, Tkacs NC. Methods of measuring insulin sensitivity. Biol Res Nurs 2007; 8: 305-318. [DOI:10.1177/1099800406298775] [PMID]
9. Gutch M, Kumar S, Razi SM, Gupta KK, Gupta A. Assessment of insulin sensitivity/resistance. Indian J Endocrinol Metab 2015; 19: 160-164. [DOI:10.4103/2230-8210.146874] [PMID] [PMCID]
10. Henderson M, Rabasa-Lhoret R, Bastard JP, Chiasson JL, Baillargeon JP, Hanley J, et al. Measuring insulin sensitivity in youth: How do the different indices compare with the gold-standard method?. Diabetes Metab 2011; 37: 72-78. [DOI:10.1016/j.diabet.2010.06.008] [PMID]
11. Kite CS, Lahart IM, Afzal I, Broom D, Kyrou I, Randeva H, et al. Exercise interventions significantly reduce fasting insulin, but not fasting glucose, in women with polycystic ovary syndrome when compared with no intervention: A systematic review and meta-analysis. Diabetic Med 2018; 35: 60. 1-4.
12. Eftekhari MH, Ranjbar Zahedani M, Kohansal A. Comparison of metabolic syndrome components, inflammation and oxidative stress indices in normal weight obese and normal weight women: A case-control study. J Health Sci Surveillance Sys 2018; 6: 116-122.
13. Wu CZ, Lin JD, Hsia TL, Hsu CH, Hsieh CH, Chang JB, et al. Accurate method to estimate insulin resistance from multiple regression models using data of metabolic syndrome and oral glucose tolerance test. J Diabetes Investig 2014; 5: 290-296. [DOI:10.1111/jdi.12155] [PMID] [PMCID]
14. Cai J, Wu CH, Zhang Y, Wang YY, Xu WD, Lin TC, et al. High-free androgen index is associated with increased risk of non-alcoholic fatty liver disease in women with polycystic ovary syndrome, independent of obesity and insulin resistance. Int J Obes 2017; 41: 1341-1347. [DOI:10.1038/ijo.2017.116] [PMID]
15. Park SY, Cho YJ, Lee SR, Chung H, Jeong K. Triglyceride is a useful surrogate marker for insulin resistance in Korean women with polycystic ovary syndrome. Yonsei Med J 2015; 56: 785-792. [DOI:10.3349/ymj.2015.56.3.785] [PMID] [PMCID]
16. Group REASPCW. Revised 2003 consensus on diagnostic criteria and long‐term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19: 41-47. [DOI:10.1093/humrep/deh098] [PMID]
17. Majid H, Masood Q, Khan AH. Homeostatic model assessment for insulin resistance (HOMA-IR): A better marker for evaluating insulin resistance than fasting insulin in women with polycystic ovarian syndrome. J Coll Physicians Surg Pak 2017; 27: 123-126.
18. Namvar Jahromi B, Dabaghmanesh MH, Parsanezhad ME, Fatehpoor F. Association of leptin and insulin resistance in PCOS: A case-controlled study. Int J Reprod Biomed 2017; 15: 423-428. [DOI:10.29252/ijrm.15.7.423]
19. Abu-Hijleh TM, Gammoh E, Al-Busaidi AS, Malalla ZH, Madan S, Mahmood N, et al. Common variants in the sex hormone-binding globulin (SHBG) gene influence SHBG levels in women with polycystic ovary syndrome. Ann Nutr Metab 2016; 68: 66-74. [DOI:10.1159/000441570] [PMID]
20. Barseem NF, Helwa MA. Homeostatic model assessment of insulin resistance as a predictor of metabolic syndrome: Consequences of obesity in children and adolescents. Egypt Pediatr Assoc Gazette 2015; 63: 19-24. [DOI:10.1016/j.epag.2014.12.001]
21. Okura T, Nakamura R, Fujioka Y, Kawamoto-Kitao S, Ito Y, Matsumoto K, et al. Body mass index≥ 23 is a risk factor for insulin resistance and diabetes in Japanese people: A brief report. PLoS One 2018; 13: e0201052. [DOI:10.1371/journal.pone.0201052] [PMID] [PMCID]
22. Chung JO, Cho DH, Chung DJ, Chung MY. Associations among body mass index, insulin resistance, and pancreatic β-cell function in Korean patients with new-onset type 2 diabetes. Korean J Intern Med 2012; 27: 66-71. [DOI:10.3904/kjim.2012.27.1.66] [PMID] [PMCID]
23. Gonzalez-Cantero J, Martin-Rodriguez JL, Gonzalez-Cantero A, Arrebola JP, Gonzalez-Calvin JL. Insulin resistance in lean and overweight non-diabetic Caucasian adults: Study of its relationship with liver triglyceride content, waist circumference and BMI. PLoS One 2018; 13: e0192663. [DOI:10.1371/journal.pone.0192663] [PMID] [PMCID]
24. Saito K, Matsuzaki T, Iwasa T, Miyado M, Saito H, Hasegawa T, et al. Steroidogenic pathways involved in androgen biosynthesis in eumenorrheic women and patients with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2016; 158: 31-37. [DOI:10.1016/j.jsbmb.2016.02.010] [PMID]
25. Laurent MR, Hammond GL, Blokland M, Jardí F, Antonio L, Dubois V, et al. Sex hormone-binding globulin regulation of androgen bioactivity in vivo: Validation of the free hormone hypothesis. Sci Rep 2016; 6: 35539. 1-12. [DOI:10.1038/srep35539] [PMID] [PMCID]
26. Pavičić Baldani D, Škrgatić L, Bukvić Mokos Z, Trgovčić I. Hyperandrogenemia association with acne and hirsutism severity in Croatian women with polycystic ovary syndrome. Acta Dermatovenerol Croat 2013; 21: 105-112.
27. Le TN, Nestler JE, Strauss JF, Wickham EP. Sex hormone-binding globulin and type 2 diabetes mellitus. Trends Endocrinol Metab 2012; 23: 32-40. [DOI:10.1016/j.tem.2011.09.005] [PMID] [PMCID]
28. Stepto NK, Cassar S, Joham AE, Hutchison SK, Harrison CL, Goldstein RF, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod 2013; 28: 777-784. [DOI:10.1093/humrep/des463] [PMID]
29. Watson CS. Prediabetes: Screening, diagnosis and intervention. J Nurse Practitioner 2017; 13: 216-221. [DOI:10.1016/j.nurpra.2016.08.005]
30. Naderpoor N, Shorakae S, De Courten B, Misso ML, Moran LJ, Teede HJ. Metformin and lifestyle modification in polycystic ovary syndrome: Systematic review and meta-analysis. Hum Reprod Update 2015; 21: 560-574. [DOI:10.1093/humupd/dmv025] [PMID]
31. Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the study of diabetes (EASD). Diabetologia 2018; 61: 2461-2498. [DOI:10.1007/s00125-018-4729-5] [PMID]
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