Insulin Resistance in Obese and Non-obese PCOS Patients using Homeostasis Model Assessment – Insulin Resistant: A Comparison Study

Abstract

Aim: this study was conducted to assess the insulin resistance in obese PCOS patients in comparison with non-obese PCOS women. Methodology: a comparative observational study was conducted on 165 Libyan PCOS women; 81 obese PCOS and 84 non-obese PCOS attending the out-patient clinic of Albayda Fertility Teaching Center and two private clinics in Albayda city/Libya, in the period between January 2021 and January 2023. All subjects undergone day 2 pelvic ultrasound scan, relevant hormonal assay and an overnight insulin and glucose levels were measured and used for insulin resistance calculation, using Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) formula, 2.6 was used as a HOMA-IR cutoff value. Result: of the total 165 PCOS women, 81 (49%) were obese with BMI ≥30 kg/m2 (study group) and 84 (51%) were non-obese (control group) PCOS. The prevalence of insulin resistance (IR) in all the included PCOS patients was 39% and the difference in prevalence of IR was non-significant between obese and non-obese PCOS (p=0.44). Insulin resistance was significantly higher among the obese PCOS (mean HOMA-IR =3) than non-obese PCOS group (mean HOMA-IR = 2.4) with P-value < 0.001. Insulin resistance had a significant positive correlation with fasting insulin and glucose levels but was not significantly correlated with BMI, age, LH, or with testosterone. Conclusion: both obese and non-obese PCOS women have insulin resistance, strengthening the aetiological role of Insulin resistance in PCOS pathogenesis. However, the insulin resistance was significantly higher among the obese PCOS accordingly life-style modifications might be beneficial in restoring PCOS pathogenesis.