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Cited by 62Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGestational Diabetes Research and Management

Assessment of insulin resistance in lean women with polycystic ovary syndrome

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Morciano, Andrea, Romani, Federica, Sagnella, Francesca, Scarinci, Elisa, Palla, Carola, Moro, Francesca, Tropea, Anna, Policola, Caterina +4 more·2014·Fertility and Sterility
DOI 10.1016/j.fertnstert.2014.04.004
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Abstract

Objective To develop and validate a specific simple measure of insulin sensitivity using oral glucose tolerance test (OGTT) values for lean polycystic ovary syndrome (PCOS) women. Design Retrospective study. Setting Gynecologic Outpatient Clinic of University Hospital, affiliated with Unit of Gynecologic Endocrinology. Patient(s) Totals of 201 lean and 198 overweight/obese (ov-ob) nondiabetic PCOS patients were retrospectively selected. Intervention(s) None. Main outcome measure(s) All patients underwent OGTT, euglycemic-hyperinsulinemic clamp, and androgenic and biochemical assays. The predictive performance of each insulin resistance (IR) index was analyzed with the use of receiver operating characteristic (ROC) curves. Result(s) Higher correlation coefficients with clamp studies were obtained with the Belfiore Area (RS=0.579) and the homeostasis-model assessment (HOMA)-M120 (RS=-0.576) in lean PCOS patients and with the Sib (RS=0.697) in ov-ob PCOS patients. The best predictive index of IR in lean PCOS was a HOMA-M120 value of ≥12.8 or more (area under the ROC curve [AUC] 92.4%). In the ov-ob PCOS population, the best predictive performance was obtained by a Sib of ≤10.2 or less (AUC 85.7%). Conclusion(s) IR should be assessed in all PCOS women, both lean and ov-ob subjects. The HOMA-M120 resulted as a very simple tool, validated specifically for the lean PCOS woman whose cardiometabolic impairment is more frequently misunderstood.

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  • It is likely that all women with PCOS, whether obese or lean, have reduced insulin sensitivity.

    “When the physiology of insulin function is considered to be a quantitative or continuous variable from an evolutionary perspective, it is likely that all women with PCOS, whether obese or lean, have reduced insulin sensitivity [152,155,166].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [166]

  • Studies comparing obese and lean women with PCOS have several methodological problems including small sample size, overlap of PCOS characteristics with normal pubertal changes, non-standardized diagnostic criteria, and limited generalizability due to a focus on a specific ethnic group.

    “Studies comparing obese and lean women with PCOS have several methodological problems including small sample size, overlap of PCOS characteristics with normal pubertal changes, non-standardized diagnostic criteria, and limited generalizability to the entire population due to a focus on a specific ethnic group [166,182].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [166]

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Authors
Morciano, A., Romani, F., Sagnella, F., Scarinci, E., Palla, C., Moro, F., Tropea, A., Policola, C., Della Casa, S., Guido, M., Lanzone, A., & Apa, R.
Affiliations
Università Cattolica del Sacro Cuore (IT)
Corresponding author
Romani, Federica
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2014-07
Volume
102
Issue
1
Pages
250-256.e3
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2014.04.004
OpenAlex
W2073836854
Cited by
62
References
46
Citations by year
2026: 3 · 2025: 6 · 2024: 16 · 2023: 6 · 2022: 8 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 1 · 2015: 2
FWCI
3.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
polycystic ovary syndrome, insulin resistance, lean women, insulin sensitivity index, hyperinsulinemic-euglycemic clamp, obesity, cardiometabolic risk
MeSH terms
Adolescent, Adult, Blood Glucose, Female, Glucose Tolerance Test, Humans, Insulin, Insulin Resistance, Obesity, Polycystic Ovary Syndrome, Predictive Value of Tests, Retrospective Studies, ROC Curve, Thinness, Reproducibility of Results, Glucose Clamp Technique, Biomarkers, Area Under Curve, Young Adult

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