Insulin Resistance Markers In Women Research Articles

A New Predictor for Insulin Resistance in Polycystic Ovary Syndrome: InsuTAG

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS leads to metabolic dysfunction such as dyslipidemia, obesity, and glucose intolerance based on hyperandrogenemia, hyperinsulinemia, and dysregulated adipokine secretion. Objective: The aim of this study was to investigate whether a new marker, InsuTAG (fasting insulin×fasting triglycerides) could predict insulin resistance (IR) in patients of PCOS. Methods: In this study, retrospective data of 300 female patients diagnosed with PCOS were analyzed. The relationship between InsuTAG and HOMA-IR, TyG, and TG/HDL-C scores related to insulin resistance was evaluated. In addition, the distribution of the cases according to the cut-off values was determined. Results: Log-transformed forms of InsuTAG and HOMA-IR, TyG and TG/HDL-C results were positively correlated, respectively. (r = 0.85, p < 0.001; r = 0.78, p < 0.001; r = 0.72, p < 0.001). Sensitivity, specificity, positive predictive value and negative predictive values for InsuTAG were calculated as 85%, 85%, 82% and 88%, respectively. Conclusions: This study is the first to compare the InsuTAG, another predictor of insulin resistance, with other IR markers in women with PCOS. InsuTAG is a novel biomarker based on plasma sampling of insulin and triglyceride, with minimally invasive, inexpensive and orientally accessible features.

The HOMA-Adiponectin (HOMA-AD) Closely Mirrors the HOMA-IR Index in the Screening of Insulin Resistance in the Brazilian Metabolic Syndrome Study (BRAMS).

BackgroundThe major adverse consequences of obesity are associated with the development of insulin resistance (IR) and adiposopathy. The Homeostasis Model Assessment-Adiponectin (HOMA-AD) was proposed as a modified version of the HOMA1-IR, which incorporates adiponectin in the denominator of the index.ObjectivesTo evaluate the performance of the HOMA-AD index compared with the HOMA1-IR index as a surrogate marker of IR in women, and to establish the cutoff value of the HOMA-AD.Subjects/MethodsThe Brazilian Metabolic Syndrome Study (BRAMS) is a cross-sectional multicenter survey. The data from 1,061 subjects met the desired criteria: 18–65 years old, BMI: 18.5–49.9 Kg/m² and without diabetes. The IR was assessed by the indexes HOMA1-IR and HOMA-AD (total sample) and by the hyperglycemic clamp (n = 49). Metabolic syndrome was defined using the IDF criteria.ResultsFor the IR assessed by the clamp, the HOMA-AD demonstrated a stronger coefficient of correlation (r = -0.64) compared with the HOMA1-IR (r = -0.56); p < 0.0001. In the ROC analysis, compared with the HOMA1-IR, the HOMA-AD showed higher values of the AUC for the identification of IR based on the clamp test (AUC: 0.844 vs. AUC: 0.804) and on the metabolic syndrome (AUC: 0.703 vs. AUC: 0.689), respectively; p < 0.001 for all. However, the pairwise comparison did not show evidence of superiority for the HOMA-AD in comparison with the HOMA1-IR in the diagnosis of IR and metabolic syndrome (p > 0.05). The optimal cutoff identified for the HOMA-AD for the diagnosis of IR was 0.95.ConclusionsThe HOMA-AD index was demonstrated to be a useful surrogate marker for detecting IR among adult women and presented a similar performance compared with the HOMA1-IR index. These results may assist physicians and researchers in determining which method to use to evaluate IR in light of the available facilities.

Serum ferritin is associated with markers of insulin resistance in Japanese men but not in women

ObjectiveSeveral epidemiological studies have reported that high concentrations of circulating ferritin, a marker of iron stores, are related to insulin resistance (IR); however, questions remain regarding inconsistent data between Asian men and women and the inadequate consideration of potential confounding effects on the relationship between ferritin and IR. Our aim was to examine the relationship between serum ferritin concentrations and IR markers in the Japanese population. Materials/MethodsWe analyzed data (n=493) from a cross-sectional survey conducted in 2009 among a Japanese working population aged 20–68years. Fasting serum ferritin and insulin levels and fasting plasma glucose levels were determined, and the homeostatic model assessment of IR (HOMA-IR) was calculated. Multiple regression analysis was performed with adjustments for demographic and lifestyle factors, body mass index and serum C-reactive protein. ResultsFasting insulin and HOMA-IR significantly increased with increasing levels of serum ferritin after adjustment for covariates in men (P for trend=.005 and .001, respectively). Compared with men in the lowest tertile of serum ferritin, those in the highest tertile had a 24% higher HOMA-IR score. Additional data suggested a positive association between iron intake and HOMA-IR (P for trend=.07) in men. Neither serum ferritin nor iron intake was related to IR markers in women, even in postmenopausal women. ConclusionsSerum ferritin concentrations were positively associated with fasting insulin and HOMA-IR in men but not in women, suggesting an important role of iron storage in the pathogenesis of IR in Japanese men.

Serum complement C3 has a stronger association with insulin resistance than high-sensitivity C-reactive protein in women with polycystic ovary syndrome

To compare the association of complement C3 (C3) versus high-sensitivity C-reactive protein (hs-CRP) with insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). Cross-sectional analysis. Clinical research center in China. One hundred thirty-three women with PCOS and 116 healthy, age-matched controls were recruited. None. One hundred one women with PCOS and 20 controls underwent hyperinsulinemic-euglycemic clamp to assess their insulin sensitivity, which was expressed as an M value. Compared with controls, women with PCOS had a lower M value and higher C3 (1.37 ± 0. 34 vs. 1.10 ± 0.22 g/L) and hs-CRP levels (1.46 ± 2.29 vs. 0.49 ± 0.88 mg/L). In women with PCOS, C3 and hs-CRP negatively correlated with M value (r = -0.61 and r = -0.47, respectively). By regression analysis, C3 was found to have a greater impact on the M value (standardized coefficient β = -0.24) than did hs-CRP (standardized coefficient β = -0.13). After adjusting for body mass index (BMI), women with PCOS in the upper quartile were 4.30 times more likely to exhibit IR compared with those in the lower quartiles, whereas hs-CRP was not a statistically significant predictor of IR in women with PCOS. Compared with hs-CRP, serum C3 might be a stronger inflammatory marker of IR in women with PCOS.

Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome

The aim of the present study is to assess insulin resistance (IR) in women with hyperandrogenic syndrome, which was suggested to replace the term polycystic ovary syndrome by the Androgen Excess Society, and to evaluate whether sex hormone-binding globulin (SHBG) can be used as a predictive marker of IR in hyperandrogenic women. Clinical, metabolic, and endocrine parameters were measured, and an oral glucose tolerance test was carried out. The women were classified as IR group or non-IR group, in accordance with defined cutoff points for the homeostatic model assessment of IR (HOMA-IR) at > or =2.5, the quantitative insulin sensitivity check index at < or = 0.33, and the Matsuda insulin sensitivity index (ISI) at < or = 5. The women classified as having IR had a significantly higher body mass index (BMI) and free androgen index (FAI) and showed significantly lower SHBG and high-density lipoprotein (HDL) levels, regardless of the indices used. However, with the Matsuda ISI, generally more women were diagnosed as having IR, and this group had significantly higher total testosterone and triglyceride values, as well as a higher incidence of hirsutism. Women who were classified as being insulin resistant using insulin sensitivity indices showed significantly higher BMI and FAI values and lower SHBG and HDL levels. However, the Matsuda ISI may be more favorable for identifying IR in hyperandrogenic women. SHBG may serve as a predictive marker of IR in these women, particularly in those who are obese.