Yıl: 2022 Cilt: 6 Sayı: 1 Sayfa Aralığı: 24 - 31 Metin Dili: İngilizce DOI: 10.25048/tudod.1041387 İndeks Tarihi: 07-09-2022

Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome

Öz:
Aim: This study aims to compare insulin resistance (IR) measurement methods in women with and without polycystic ovary syndrome (PCOS) who have the same body mass index. Material and Methods: There were 84 women with PCOS and non-PCOS (n=18 normal weight and n=24 overweight/obese in both groups). Triglyceride glucose index (TyG), assessment of insulin resistance with homeostasis model (HOMA-IR), visceral adiposity index (VAI) were calculated using lipid level, glucose level and anthropometric measurements. Mann-Whitney U or Student's t-test was used to compare measurements between the groups. The relationship between HOMA-IR and age was calculated with the Pearson correlation test, and the relationship between HOMA-IR and TyG was calculated with the Spearman correlation test. p<0.05 was considered significant. Results: Triglyceride levels, insulin, TyG, and HOMA-IR were higher in the PCOS group than in the non-PCOS group (p=0.003, p=0.001, p=0.006, p=0.001, respectively). In the PCOS group, there was a negative correlation between HOMA-IR and age (r=-0.399, p=0.024), and a positive correlation between HOMA-IR and TyG index (r=0.776, p<0.001). TyG index and HOMA-IR were higher in normal weight PCOS women than non-PCOS (p=0.002, p=0.003, respectively), however there was no difference in overweight/obese PCOS women and non-PCOS. In PCOS patients, a TyG index >3.91 (89.5% sensitivity, 76.9% specificity) predicted insulin resistance (IR). Conclusion: TyG and HOMA-IR levels are higher in women with PCOS than non-PCOS. The TyG index can be used as an alternative method in evaluating insulin resistance among these patients.
Anahtar Kelime: Polycystic ovary syndrome Insulin resistance TyG VAI HOMA-IR

Polikistik Over Sendromlu Hastalarda İnsülin Direnci Ölçüm Metodlarının Değerlendirilmesi

Öz:
Amaç: Bu çalışmada polikistik over sendromlu (PKOS) kadınlarda insülin direnci (IR) ölçüm metodlarının, aynı beden kütle indeksine sahip PKOS olmayan kadınlarla karşılaştırılması hedeflenmiştir. Gereç ve Yöntemler: Çalışmamıza PKOS (n=18 normal kilolu ve n=24 hafif kilolu/obez) ve PKOS olmayan (n=18 normal kilolu ve n=24 hafif kilolu/obez) toplam 84 kadın dahil edildi. Lipit düzeyi, glukoz düzeyi ve antropometrik ölçümler kullanılarak trigliserid glukoz indeksi (TyG), insülin direncinin homeostaz modeliyle değerlendirmesi (HOMA-IR), visseral adipozite indeksi (VAI) hesaplandı. PKOS olan ve olmayan gruplar arasında ölçüm değerlerinin karşılaştırılmasında Mann-Whitney U test ya da Student t-test kullanıldı. HOMAIR ile yaş arasındaki ilişki Pearson korelasyon testi, HOMA-IR ile TyG arasındaki ilişki Spearman korelasyon testi ile hesaplandı. p3.91 olması (%89.5 sensivite, %76.9 spesifite) insulin rezistansını (IR) predikte etti. Sonuç: PKOS’lu kadınlarda PKOS olmayanlara göre TyG ve HOMA-IR düzeyleri yüksektir. Bu hastalarda insulin rezistansı değerlendirilmesinde TyG indeksi alternatif bir metod olarak kullanılabilir
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Azziz R. Polycystic ovary syndrome. Obstet Gynecol. 2018;132(2):321-336.
  • 2. Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev. 2016;37(5):467-520.
  • 3. Osibogun O, Ogunmoroti O, Michos ED. Polycystic ovary syndrome and cardiometabolic risk: Opportunities for cardiovascular disease prevention. Trends Cardiovasc Med. 2020;30(7):399-404.
  • 4. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstet Gynecol. 2018;131(6):e157-e171.
  • 5. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: A method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab. 1979;237:E214.
  • 6. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández- González SO, Jacques-Camarena O, Rodríguez-Morán M. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic- hyperinsulinemic clamp. J Clin Endocrinol Metab 2010; 95:3347-3351.
  • 7. Vasques AC, Novaes FS, de Oliveira Mda S, Souza JR, Yamanaka A, Pareja JC, Tambascia MA, Saad MJ, Geloneze B. TyG index performs better than HOMA in a Brazilian population: A hyperglycemic clamp validated study. Diabetes Res Clin Pract. 2011;93:e98-e100
  • 8. Shin KA. Triglyceride and glucose (TyG) index is a clinical surrogate marker for the diagnosis of metabolic syndrome. J Biomedical Science Letters. 2017;23:348-54.
  • 9. Kim B, Choi HY, Kim W, Ahn C, Lee J, Kim JG, Kim J, Shin H, Yu JM, Moon S. The cut-off values of surrogate measures for insulin resistance in the Korean population according to the Korean Genome and Epidemiology Study (KOGES). PLoS One. 2018;13:e0206994.
  • 10. Park K, Ahn CW, Lee SB, Kang S, Nam JS, Lee BK, Kim JH, Park JS. Elevated TyG index predicts progression of coronary artery calcification. Diabetes Care. 2019;42:1569-1573.
  • 11. Brończyk-Puzoń A, Jagielski P, Kulik-Kupka K, Koszowska A, Nowak J, Zubelewicz-Szkodzińska B. Usefulness of a new anthropometric indicator - VAI (Visceral Adiposity Index) in the evaluation of metabolic and hormonal disorders in women with polycystic ovarysyndrome. Adv Clin Exp Med. 2017;26(5):825-828.
  • 12. Zheng SH, Li XL. Visceral adiposity index as a predictor of clinical severity and therapeutic outcome of PCOS. Gynecol Endocrinol. 2016;32(3):177-183.
  • 13. Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E; American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE); Androgen Excess and PCOS Society (AES). American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome- Part 1. Endocr Pract. 2015;21(11):1291-1300.
  • 14. World Health Organization. WHO fact sheet on overweight and obesity. Updated June 2021. (Accessed December 25, 2021, at https://www.who.int/news-room/fact-sheets/detail/ obesity-and-overweight.)
  • 15. Sasaki A, Emi Y, Matsuda M, Sharula, Kamada Y, Chekir C, Hiramatsu Y, Nakatsuka M. Increased arterial stiffness in mildly-hypertensive women with polycystic ovary syndrome. J Obstet Gynaecol Res. 2011;37(5):402-411.
  • 16. Amato MC, Verghi M, Galluzzo A, Giordano C. The oligomenorrhoic phenotypes of polycystic ovary syndrome are characterized by a high visceral adiposity index: A likely condition of cardiometabolic risk. Hum Reprod. 2011;26:1486- 1494.
  • 17. Millan J, Pinto X, Munoz A, Zuniga M, Rubies-Prat J, Pallardo LF, Masana L, Mangas A, Hernandez-Mijares A, Gonzalez-Santos P, Ascaso JF, Pedro-Botet J. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag. 2009;5:757-765.
  • 18. McLaughlin T, Reaven G, Abbasi F, Lamendola C, Saad M, Waters D, Simon J, Krauss RM. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol. 2005; 96: 399-404
  • 19. Yildizhan B, Anik Ilhan G, Pekin T. The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovarysyndrome. J Obstet Gynaecol. 2016;36:893-896.
  • 20. Dickerson EH, Cho LW, Maguiness SD, Killick SL, Robinson J, Atkin SL. Insulin resistance and free androgen index correlate with the outcome of controlled ovarian hyperstimulation in non-PCOS women undergoing IVF. Hum Reprod. 2010;25(2):504-509.
  • 21. Ungera G, Benozzia SF, Perruzzab F, Pennacchiottia GL. Triglycerides and glucose index: A useful indicator of insulin resistance. Endocrinol Nutr. 2014;61(10):533-540
  • 22. Hackbart KS, Cunha PM, Meyer RK, Wiltbank MC. Effect of glucocorticoid-induced insulin resistance on follicle development and ovulation. Biol Reprod. 2013;88:153.
  • 23. Belani M, Purohit N, Pillai P, Gupta S. Modulation of steroidogenic pathway in rat granulosa cells with subclinical Cd exposure and insulin resistance: An impact on female fertility. Biomed Res Int. 2014;2014:460251.
  • 24. Yildiz BO, Bozdag G, Yapici Z, Esinler I, Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012;27(10):3067-3073.
  • 25. Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z, Kark JD. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016;374(25):2430-2440.
  • 26. Carmina E, Lobo RA. Is there really increased cardiovascular morbidity in women with polycystic ovary syndrome? J Womens Health (Larchmt). 2018;27(11):1385-1388.
  • 27. Dumesic DA, Akopians AL, Madrigal VK, Ramirez E, Margolis DJ, Sarma MK, Thomas AM, Grogan TR, Haykal R, Schooler TA, Okeya BL, Abbott DH, Chazenbalk GD. Hyperandrogenism accompanies increased intra-abdominal fat storage in normal weight polycystic ovary syndrome women. J Clin Endocrinol Metab. 2016;101(11):4178-4188.
  • 28. Lath R, Shendye R, Jibhkate A. Insulin resistance and lipid profile in polycystic ovary syndrome. Asian J Biomed Pharm Sci. 2015;5:30.
  • 29. Matos LN, Giorelli GDV, Dias CB. Correlation of anthropometric indicators for identifying insulin sensitivity and resistance. Sao Paulo Medical Journal. 2011;129:30-35.
  • 30. Ramezani Tehrani F, Minooee S, Azizi F. Comparison of various adiposity indexes in women with polycystic ovary syndrome and normo-ovulatory non-hirsute women: A population- based study. Eur J Endocrinol. 2014;171(2):199-207.
  • 31. Abruzzese GA, Cerrrone GE, Gamez JM, Graffigna MN, Belli S, Lioy G, Mormandi E, Otero P, Levalle OA, Motta AB. Lipid accumulation product (LAP) and visceral adiposity index (VAI) as markers of insulin resistance and metabolic associated disturbances in young argentine women with polycystic ovary syndrome. Horm Metab Res. 2017;49(1):23-29.
  • 32. Dawood A, Alkafrawy N, Saleh S, Noreldin R, Zewain S. The relationship between IL-18 and atherosclerotic cardiovascular risk in Egyptian lean women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34:294-297.
  • 33. 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. Assessment of insulin resistance in lean women with polycystic ovary syndrome. Fertil Steril. 2014;102:250-256.
  • 34. Carmina E, Bucchieri S, Esposito A, Del Puente A, Mansueto P, Orio F, Di Fede G, Rini G. Abdominal fat quantity and distribution in women with polycystic ovary syndrome and extent of its relation to insulin resistance. J Clin Endocrinol Metab. 2007;92:2500-2505.
  • 35. Vilmann LS, Thisted E, Baker JL, Holm JC. Development of obesity and polycystic ovary syndrome in adolescents. Horm Res Paediatr. 2012;78:269-278.
  • 36. Fang H, Berg E, Cheng X, Shen W. How to best assess abdominal obesity. Curr Opin Clin Nutr Metab Care. 2018; 21(5):360-365.
  • 37. Bray GA, DeLany JP, Volaufova J, Harsha DW, Champagne C. Prediction of body fat in 12-y-old African American and white children: Evaluation of methods. Am J Clin Nutr. 2002;76(5):980-990.
  • 38. Jeanes YM, Reeves S. Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: Diagnostic and methodological challenges. Nutr Res Rev. 2017;30(1):97- 105.
  • 39. Bil E, Dilbaz B, Cirik DA, Ozelci R, Ozkaya E, Dilbaz S. Metabolic syndrome and metabolic risk profile according to polycystic ovary syndrome phenotype. J Obstet Gynaecol Res. 2016; 42:837-843.
APA Bilginer M, TÜFEKÇİ D, EMÜR GÜNAY Y, USTA O, Coşkun H, ÜÇÜNCÜ Ö, nuhoglu i, KOCAK M (2022). Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. , 24 - 31. 10.25048/tudod.1041387
Chicago Bilginer Muhammet Cuneyt,TÜFEKÇİ Damla,EMÜR GÜNAY YASEMİN,USTA OGUZER,Coşkun Hülya,ÜÇÜNCÜ Özge,nuhoglu irfan,KOCAK Mustafa Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. (2022): 24 - 31. 10.25048/tudod.1041387
MLA Bilginer Muhammet Cuneyt,TÜFEKÇİ Damla,EMÜR GÜNAY YASEMİN,USTA OGUZER,Coşkun Hülya,ÜÇÜNCÜ Özge,nuhoglu irfan,KOCAK Mustafa Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. , 2022, ss.24 - 31. 10.25048/tudod.1041387
AMA Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. . 2022; 24 - 31. 10.25048/tudod.1041387
Vancouver Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. . 2022; 24 - 31. 10.25048/tudod.1041387
IEEE Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M "Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome." , ss.24 - 31, 2022. 10.25048/tudod.1041387
ISNAD Bilginer, Muhammet Cuneyt vd. "Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome". (2022), 24-31. https://doi.org/10.25048/tudod.1041387
APA Bilginer M, TÜFEKÇİ D, EMÜR GÜNAY Y, USTA O, Coşkun H, ÜÇÜNCÜ Ö, nuhoglu i, KOCAK M (2022). Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. Türkiye Diyabet ve Obezite Dergisi , 6(1), 24 - 31. 10.25048/tudod.1041387
Chicago Bilginer Muhammet Cuneyt,TÜFEKÇİ Damla,EMÜR GÜNAY YASEMİN,USTA OGUZER,Coşkun Hülya,ÜÇÜNCÜ Özge,nuhoglu irfan,KOCAK Mustafa Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. Türkiye Diyabet ve Obezite Dergisi 6, no.1 (2022): 24 - 31. 10.25048/tudod.1041387
MLA Bilginer Muhammet Cuneyt,TÜFEKÇİ Damla,EMÜR GÜNAY YASEMİN,USTA OGUZER,Coşkun Hülya,ÜÇÜNCÜ Özge,nuhoglu irfan,KOCAK Mustafa Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. Türkiye Diyabet ve Obezite Dergisi , vol.6, no.1, 2022, ss.24 - 31. 10.25048/tudod.1041387
AMA Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. Türkiye Diyabet ve Obezite Dergisi . 2022; 6(1): 24 - 31. 10.25048/tudod.1041387
Vancouver Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome. Türkiye Diyabet ve Obezite Dergisi . 2022; 6(1): 24 - 31. 10.25048/tudod.1041387
IEEE Bilginer M,TÜFEKÇİ D,EMÜR GÜNAY Y,USTA O,Coşkun H,ÜÇÜNCÜ Ö,nuhoglu i,KOCAK M "Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome." Türkiye Diyabet ve Obezite Dergisi , 6, ss.24 - 31, 2022. 10.25048/tudod.1041387
ISNAD Bilginer, Muhammet Cuneyt vd. "Evaluation of Insulin Resistance Measurement Methods in Patients with Polycystic Ovary Syndrome". Türkiye Diyabet ve Obezite Dergisi 6/1 (2022), 24-31. https://doi.org/10.25048/tudod.1041387