Amisi Chantal Anifa, Ciccozzi Massimo, Pozzilli Paolo
Endocrinology and Diabetes Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy.
Medical Statistics and Epidemiology Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy.
World J Diabetes. 2020 Feb 15;11(2):42-51. doi: 10.4239/wjd.v11.i2.42.
Insulin resistance (IR) is the main complication found in 35%-80% of women with polycystic ovary syndrome (PCOS). However, there is no definite consensus regarding which marker to use for its assessment in PCOS women. Research has shown that hyperinsulinemia is correlated with increased bone mass. Given that most women with PCOS are insulin resistant, which is independent from body fat and characterized by hyperinsulinemia, it could be hypothesized that there would be an increased bone mass in the patient as a result. Subsequently, increased bone mass could be measured using the wrist circumference method.
To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.
Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group, were enrolled in the study (mean age 24.33 ± 5.36 years). Fasting biochemical parameters, and the Homeostasis Model Assessment of insulin resistance (HOMA-IR) and body composition were evaluated. The non-dominant wrist circumference was measured manually, as was the waist circumference (WC), hip circumference, height and weight. Calculated measures included evaluation of body mass index (BMI), Waist-to-Height (WHtR) and Waist-to-hip ratio (WHR). In addition, body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.
The non-dominant wrist circumference was more closely correlated with HOMA-IR ( = 0.346; = 0.003) and was the best anthropometrical marker correlated with IR ( = 0.011 ) compared with other anthropometrical markers in women with PCOS: Dominant Wrist Circumference ( = 0.315; = 0.007), Waist Circumference (WC) ( = 0.259; = 0.028), BMI ( = 0.285; = 0.016), WHR ( = 0.216; = 0,068) and WHtR ( = 0.263; = 0.027). The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic (ROC) curve analysis showed that the area under the ROC curve was 0.72. A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR in Congolese women with PCOS.
Non-dominant wrist circumference is, to date, the best anthropometrical marker of IR in Sub-Saharan African women with PCOS. It could be suggested as an easy-to-detect marker for assessing IR.
胰岛素抵抗（IR）是35%-80%多囊卵巢综合征（PCOS）女性中发现的主要并发症。然而，对于在PCOS女性中使用哪种标志物来评估胰岛素抵抗，目前尚无明确共识。研究表明，高胰岛素血症与骨量增加相关。鉴于大多数PCOS女性存在胰岛素抵抗，且这种抵抗独立于体脂，以高胰岛素血症为特征，因此可以推测这些患者的骨量会增加。随后，可以使用腕围法来测量增加的骨量。
评估腕围作为刚果PCOS女性中一种易于检测的IR标志物。
本研究纳入了72名刚果PCOS女性和71名同种族对照者（平均年龄24.33±5.36岁）。评估了空腹生化参数、胰岛素抵抗稳态模型评估（HOMA-IR）和身体成分。手动测量非优势腕围，同时测量腰围（WC）、臀围、身高和体重。计算指标包括体重指数（BMI）、腰高比（WHtR）和腰臀比（WHR）的评估。此外，使用体脂分析仪通过生物电阻抗分析评估身体成分。
与PCOS女性的其他人体测量学标志物相比，非优势腕围与HOMA-IR的相关性更强（r = 0.346；P = 0.003），并且是与IR相关性最好的人体测量学标志物（P = 0.011）：优势腕围（r = 0.315；P = 0.007）、腰围（WC）（r = 0.259；P = 0.028）、BMI（r = 0.285；P = 0.016）、WHR（r = 0.216；P = 0.068）和WHtR（r = 0.263；P = 0.027）。使用受试者工作特征（ROC）曲线分析非优势腕围对IR存在与否的诊断准确性表明，ROC曲线下面积为0.72。发现非优势腕围的截断值为16.3 cm是刚果PCOS女性中IR的最佳预测指标。
迄今为止，非优势腕围是撒哈拉以南非洲PCOS女性中IR的最佳人体测量学标志物。可以将其作为评估IR的一种易于检测的标志物。
