Эндокринология и метаболический синдром
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Does Polycystic Ovarian Syndrome Increase Insulin Resistance Above and Beyond Obesity?

Marilyn Tan and Sun H. Kim

Objective: Although obesity and insulin resistance are common in women with polycystic ovarian syndrome (PCOS), PCOS is generally believed to independently raise the risk of insulin resistance. However, only a few studies have used direct measures of insulin resistance, and they have included few subjects. The objective of this study was to compare the relationship between body mass index (BMI) and insulin resistance in a relatively large sample size of women, with and without PCOS, using a specific measure of insulin action.

Methods: We compared 94 women with PCOS based on the 1990 NIH criteria with 72 controls with eumenorrhea less than 40 years old. Degree of insulin resistance was quantified using the insulin suppression test. Fasting glucose and lipid concentrations and blood pressure were also measured.

Results: There was a significant and comparable relationship between BMI and insulin resistance in women with and without PCOS (r=0.55, p<0.001 in PCOS, r=0.53, p<0.001 in Control). In a linear model adjusted for age and BMI, PCOS was not significantly associated with insulin resistance. PCOS was significantly associated with systolic blood pressure (p=0.03) but not triglyceride, high-density lipoprotein cholesterol and fasting glucose concentration.

Conclusion: Challenging previous studies, we find that PCOS is not independently associated with insulin resistance beyond obesity. PCOS, however, may independently increase systolic blood pressure.