Failure of mathematical indices to accurately assess insulin resistance in lean, overweight, or obese women with polycystic ovary syndrome
Abstract
Insulin resistance is a common metabolic feature of polycystic ovary syndrome (PCOS). In this study, we examined the validity of the mathematical indices [the quantitative insulin sensitivity check index (QUICKI) and the homeostasis model of assessment (HOMA)] that calculate insulin sensitivity and their correlation to glucose utilization with the insulin infusion rate in 40 mU/m2·min by the euglycemic clamp (M) in women with PCOS. We studied 59 women with PCOS (20 lean, 16 overweight, and 23 obese subjects). Euglycemic clamp testing was performed, and QUICKI, HOMA, total testosterone, fasting insulin, fasting glucose, and glucose-to-insulin ratio were estimated. No difference was found in testosterone and glucose levels among the three groups. Lean or overweight women compared with obese women differed in insulin levels, glucose-to-insulin ratio, QUICKI, and HOMA (P < 0.01). No statistical difference was found between lean and overweight women in the above parameters. M differed when lean women were compared with overweight (P < 0.002) or obese women (P < 0.0001); however, no statistical difference was observed between overweight and obese women. No significant correlation was found between M and QUICKI or HOMA. We conclude that mathematical indices should be applied with caution in different insulin-resistant populations and should not be considered a priori equivalent to the euglycemic clamp technique.
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Measurement of insulin resistance is difficult.
“measurement is difficult [147,148]”
From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [147]
Reported prevalence rates of insulin resistance in obese and lean women with PCOS vary widely.
“reported prevalence rates in obese and lean women vary widely [147,152]”
From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [147]
The Results and Discussion (page not provided) compare insulin-sensitivity measures in lean, overweight, and obese women with PCOS and note variability in glucose utilization. They do not report or compare prevalence rates of insulin resistance in those groups. A search for “prevalence” found only a reference about PCOS prevalence, not the claimed rates. (LLM, conf=0.76)
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- Authors
- Diamanti-Kandarakis, E., Kouli, C., Alexandraki, K., & Spina, G.
- Affiliations
- Endocrine Section of the First Department of Internal Medicine, Athens University School of Medicine, Laiko General Hospital, Athens 115 27, Greece
- National and Kapodistrian University of Athens (GR)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-03-01
- Volume
- 89
- Issue
- 3
- Pages
- 1273-1276
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1991026143
- Semantic Scholar
- 3448fd8dce54eb0f47cd9ccc88956e245ae0af6f
- Cited by
- 150
- References
- 11
- Citations by year
- 2025: 2 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 7 · 2014: 9 · 2013: 7 · 2012: 4
- FWCI
- 15.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (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 › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- insulin resistance, polycystic ovary syndrome, QUICKI, HOMA, insulin sensitivity index, euglycemic clamp, glucose utilization, body weight, obesity, lean women, overweight women, testosterone, glucose-to-insulin ratio
- MeSH terms
- Adult, Female, Humans, Insulin Resistance, Mathematics, Obesity, Polycystic Ovary Syndrome, Reproducibility of Results, Glucose Clamp Technique, Body Mass Index
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