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Cited by 453Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGestational Diabetes Research and Management

Detecting Insulin Resistance in Polycystic Ovary Syndrome: Purposes and Pitfalls

Legro, Richard S., Castracane, V. Daniel, Kauffman, Robert P.·2004·Obstetrical & Gynecological Survey
DOI 10.1097/01.ogx.0000109523.25076.e2
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Abstract

Approximately 50% to 70% of all women with polycystic ovary syndrome (PCOS) have some degree of insulin resistance, and this hormone insensitivity probably contributes to the hyperandrogenism that is responsible for the signs and symptoms of PCOS. Although uncertainty exists, early detection and treatment of insulin resistance in this population could ultimately reduce the incidence or severity of diabetes mellitus, dyslipidemia, hypertension, and cardiovascular disease. Even if that proves to be the case, there are still several problems with our current approach to insulin sensitivity assessment in PCOS, including the apparent lack of consensus on what defines PCOS and "normal" insulin sensitivity, ethnic and genetic variability, the presence of other factors contributing to insulin resistance such as obesity, stress, and aging, and concern about whether simplified models of insulin sensitivity have the precision to predict treatment needs, responses, and future morbidity. Although the hyperinsulinemic-euglycemic clamp technique is the gold standard for measuring insulin sensitivity, it is too expensive, time-consuming, and labor-intensive to be of practical use in an office setting. Homeostatic measurements (fasting glucose/insulin ratio or homeostatic model assessment [HOMA] value) and minimal model tests (particularly the oral glucose tolerance test [OGTT]) represent the easiest office-based assessments of insulin resistance in the PCOS patient. The OGTT is probably the best simple, office-based method to assess women with PCOS because it provides information about both insulin resistance and glucose intolerance. The diagnosis of glucose intolerance holds greater prognostic and treatment implications. All obese women with PCOS should be screened for the presence of insulin resistance by looking for other stigmata of the insulin resistance syndrome such as hypertension, dyslipidemia, central obesity, and glucose intolerance.

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Authors
Legro, R. S., Castracane, V. D., & Kauffman, R. P.
Affiliations
  • Pennsylvania State University (US)
  • Texas Tech University (US)
Corresponding author
Legro, Richard S.
ORCID
Venue
Obstetrical & Gynecological Survey
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-02
Volume
59
Issue
2
Pages
141-154
ISSN
0029-7828 (ISSN-L)
DOI
10.1097/01.ogx.0000109523.25076.e2
OpenAlex
W1994522591
Semantic Scholar
077fbc1108fa531f8ab84b6cceeca0dc74ee5115
Cited by
453
References
88
Citations by year
2026: 12 · 2025: 11 · 2024: 12 · 2023: 25 · 2022: 20 · 2021: 21 · 2020: 10 · 2019: 14 · 2018: 16 · 2017: 20 · 2016: 15 · 2015: 30 · 2014: 32 · 2013: 24 · 2012: 32
FWCI
3.79
Type
journal article
Language
en
Open access
closed
Locations
  • Obstetrical & Gynecological Survey (publishedVersion)
  • PubMed (publishedVersion)
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, hyperinsulinemic-euglycemic clamp, HOMA, oral glucose tolerance test, impaired glucose tolerance, hyperandrogenism, metabolic syndrome, obesity, cardiovascular risk, dyslipidemia, hypertension
MeSH terms
Diabetes Mellitus, Fasting, Female, Glucose Tolerance Test, Homeostasis, Humans, Hyperinsulinism, Hypoglycemic Agents, Insulin, Insulin Resistance, Polycystic Ovary Syndrome, Risk Factors, Glucose Clamp Technique, Hyperandrogenism, Glucose Intolerance

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