Assessing insulin resistance in subjects with polycystic ovarian syndrome using homeostatic model assesement for insulin resistance

Background: Polycystic ovary syndrome (PCOS) is the commonest endocrine disturbance in women of reproductive years. Homeostatic model assessment insulin resistance (HOMA-IR) is widely accepted clinical index for insulin resistance, but few studies have evaluated its role in patients with polycystic ovarian syndrome. The objective of our study is to assess the utility of HOMA-IR in assessing insulin resistance in patients with PCOS. Material and Methods: A cross sectional study was done at the section of Chemical Pathology, AKUH. Electronic medical records of 400 women diagnosed with PCOS from January 2009 to December 2010, were reviewed. HOMA was computed using the formula (fasting glucose × fasting insulin)/405, taking normal value \u3c2 in adults. Data was analyzed by SPSS 19. Results: A total of 90 premenopausal females diagnosed with PCOS were included. Mean age was 30.07±5.6 years. Mean HOMA-IR and fasting insulin to glucose ratio were 2.72 and 0.14 respectively. An overall prevalence (61%) of insulin resistance (IR) was observed. Patients (n=36) with HOMA-IR \u3c2 presented with primary infertility (2%), subfertility (11%), gestational diabetes (11%) and obesity (2%). Patients (n=38) with HOMA-IR \u3e2 had primary infertility (9%), subfertility (16.3%), gestational diabetes (23%) and obesity (5.4%). We observed a significant difference (p value \u3c0.05) between mean HOMA levels amongst subjects with impaired and normal glucose tolerance test. Conclusion: A high frequency of IR in PCOS subjects necessitates early diagnosing and HOMA-IR can be used reliably for measuring insulin resistance and can probably be applied clinically in view of its good predictive value. Keywords: HOMA-IR, PCOS, FGIR, Insulin resistanc