Hatami Hossein, Montazeri Seyed Ali, Hashemi Nazanin, Ramezani Tehrani Fahimeh
Department of Public Health, School of Public Health and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Endocrinol Metab. 2017 Jul 30;15(4):e12353. doi: 10.5812/ijem.12353. eCollection 2017 Oct.
Insulin resistance (IR) is a major cardiometabolic risk factor in females with polycystic ovary syndrome (PCOS). The euglycemic clamp is the gold standard method to measure IR. However, considering the time and cost that it takes, surrogate markers of IR are now widely used. The current study aimed at evaluating the cutoff points of even less invasive anthropometric and body composition variables to predict IR in females with PCOS.
The current cross sectional study selected 224 females with PCOS, using Rotterdam criteria, referred to reproductive endocrinology research center; 88 of which were diagnosed with insulin resistance. Receiver operating characteristics curve was used to explore the best cutoff values of each anthropometric and body composition measures. IR was defined as homeostasis model assessment formula greater or equal to 2.6: HOMA-IR = fasting insulin (mU/L) × fasting plasma glucose (mM/L)/22.5.
The highest area under the curve (0.751) was for the multiplication of waist circumference (WC) by body mass index (BMI), as a single index. The highest sensitivity and specificity were for body water (BW) percentage (82% for values greater than 32.85%) and WC (79% for values greater than 88 cm), respectively.
It was concluded that there were simple anthropometric variables; e.g., WC × BMI, percentage of BW, and WC that could help to estimate IR in clinical settings especially when the gold standard or surrogate markers of IR were unavailable.
胰岛素抵抗(IR)是多囊卵巢综合征(PCOS)女性的主要心脏代谢危险因素。正常血糖钳夹技术是测量IR的金标准方法。然而,考虑到其所花费的时间和成本,IR的替代指标目前被广泛使用。本研究旨在评估侵入性更小的人体测量学和身体成分变量的截断点,以预测PCOS女性的IR。
本横断面研究选取了224例符合鹿特丹标准的PCOS女性,她们均转诊至生殖内分泌研究中心;其中88例被诊断为胰岛素抵抗。采用受试者工作特征曲线来探索各人体测量学和身体成分指标的最佳截断值。IR定义为稳态模型评估公式大于或等于2.6:HOMA-IR = 空腹胰岛素(mU/L)×空腹血糖(mM/L)/22.5。
作为单一指标,腰围(WC)与体重指数(BMI)的乘积曲线下面积最高(0.751)。身体水分(BW)百分比(大于32.85%时灵敏度为82%)和WC(大于88 cm时灵敏度为79%)的灵敏度和特异性分别最高。
得出的结论是,存在一些简单的人体测量学变量,如WC×BMI、BW百分比和WC,在临床环境中有助于估计IR,特别是在无法获得IR的金标准或替代指标时。