Comparison of Insulin Sensitivity Levels in Women with PCOS and Women with Regular Menses

Öz

Aim: Although pathophysiology of polycystic ovary syndrome (PCOS) has not been fully understood, it has been suggested that decreasing insulin sensitivity may have a pivotal role in this disorder. In this study it was aimed that as a non invasive technique, quantitative insulin sensitivity check index-(QUICKI) levels which has reflected the insulin sensitivity status, were compared in women with PCOS and regular menses. Additionally, we evaluated whether this index may have been used in clinical practice of PCOS. Material and Method: Fifty women with PCOS and fifty age and body mass index matched healthy women with regular menses were retrospectively evaluated. Serum fasting glucose, insulin and testosterone concentrations were assessed. QUICKI and homeostasis model assessment of insulin resistance (HOMA-IR) indice was calculated. 
Results: There were no significant differences in between two groups according to both QUICKI (PCOS group=0.329±0.022 vs. Control group=0.333±0.019; p=0.39) and HOMA-IR (PCOS group=3.057±1.468 vs. Control group=2.717±1.037; p=0.184). QUICKI was not significantly correlated with glucose (p=0.136) and testosterone levels (p=0.227), whereas significantly negative correlated with both insulin (r=-0.925, p<0.001), and HOMA-IR (r=-0.95, p<0.001). 
Conclusion: Insulin sensitivity which should be appreciated a clinical condition in women with PCOS. In our country reliable reference ranges of insulin sensitivity/resistance status in PCOS still have not avaible. Therefore, it was suggested that advanced studies should prospectively execute the cut of values of insulin sensitivity in PCOS.

Anahtar Kelimeler

• PCOS,QUICKI,insulin sensitivity

Polikistik Over Sendromlu ve Normal Menstrüel Sikluslu Kadınlarda İnsülin Duyarlılığı Düzeylerinin Kıyaslanması

Öz

Amaç: Polikistik over sendromu (PKOS)’un patofizyolojisi tam olarak anlaşılamamıştır. Bununla beraber insülin direncinin sendromun gelişmesinde merkezi bir rolü olduğu düşünülmektedir. Bu çalışmada insülin duyarlılığı durumunu yansıtan non-invaziv kantitatif insülin duyarlılığı hesaplama indeksi’ nin (quantitative insulin sensitivity check index-QUICKI) değerlerini PKOS’u olan ve adet düzeni normal olan kadınlar arasında karşılaştırıldı. Ayrıca bu indeksin klinik pratikte PKOS daki insülin duyarlığı/direnci durumundaki kullanılabilirliğinin incelenmesi amaçlandı. 
Materyal ve Metot: Retrospektif olarak 50 PKOS’lu kadın ile adet düzeni normal olan, 50 sağlıklı kadın yaş ve vücut kitle indeksi kıyaslamalı incelendi. Serum açlık glukoz, insulin ve testosteron konsantrasyonları değerlendirildi. QUICKI ve insulin direncinin homeostasis model değerlendirmesi (homeostasis model assessment of insulin resistance-HOMA-IR) indeksleri hesaplandı. 
Bulgular: Her iki grup arasında QUICKI (PKOS grubu=0,329±0,022 ve kontrol grubu=0,333±0,019; p=0,39) ve HOMA-IR (PKOS grubu= 3,057±1,468 ve kontrol grubu=2,717±1,037; p=0,184) yönünden anlamlı fark bulunmadı. QUICKI ile serum açlık glukoz konsantrasyonları (p=0,136) ve serum testosteron konsantrasyonları (p=0. 227), arasında anlamlı korelasyon saptanmaz iken; hem serum açlık insülin konsantrasyonları (r=-0,925, p<0,001), hem de HOMA-IR (r=-0,95, p<0,001), arasında anlamlı negatif korelasyon saptandı. 
Sonuç: PKOS’lu kadınlarda insülin duyarlılığı değerlendirilmesi gereken bir klinik durumdur. PKOS’da ülkemize ait insülin duyarlılığı/ direnci durumlarını yansıtan güvenilir eşik değerleri halen mevcut değildir. Bundan ötürü ilerideki çalışmaların PKOS’daki insulin duyarlılığını prospektif olarak ortaya koyması önerilmektedir.

Anahtar Kelimeler

• PKOS,QUICKI,insulin duyarlılığı

Kaynakça

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