Zhu Mengyi, Wang Kaiyue, Feng Jiaxing, Liu Yang, Guan Muxin, Wang Yu, Wu Xiaoke
Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China.
First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
Front Endocrinol (Lausanne). 2024 Dec 9;15:1502321. doi: 10.3389/fendo.2024.1502321. eCollection 2024.
This study aimed to explore the role of the waist-to-height ratio (WHtR) in assessing insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS).
We enrolled 882 PCOS-afflicted women in a cross-sectional analysis to evaluate the association of the WHtR with IR. Their demographic characteristics, anthropometric parameters, and fasting blood samples were collected and measured. Moreover, IR was evaluated by homeostatic model assessment of insulin resistance (HOMA-IR). We estimated the relationship between the WHtR and IR and the cut-off thresholds of the WHtR for IR using multivariable linear regression and logistic regression models, respectively.
The prevalence rate of IR was 51.9%. The patients with PCOS and IR displayed significantly increased values for body mass index (BMI), waist circumference (WC), WHtR, systolic blood pressure (SBP), diastolic blood pressure (DBP), free androgen index (FAI), HOMA-IR, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (ApoB). However, the patients with PCOS and IR showed a reduction in estradiol (E2), luteinizing hormone (LH), LH/FSH ratio, sex hormone binding globulin (SHBG), and high-density lipoprotein (HDL-C) values than those without IR. Moreover, BMI (log-transformed), WC, and HOMA-IR (log-transformed) were positively correlated with the WHtR. When adjusting for potential confounding variables, the WHtR was significantly associated with HOMA-IR (log-transformed), with a standardized regression coefficient of 0.271. Furthermore, the WHtR was significantly associated with an increased risk of IR, with the adjusted odds ratio (OR) of 3.15 (WHtR multiplied by 10). Additionally, the WHtR helped to identify IR in women with PCOS with an optimal cut-off point of 0.519 (Youden index = 0.433).
The WHtR had a positive association with IR in women with PCOS. Hence, we suggest that the WHtR, as a simple, practical, and reliable anthropometric measure, can be used to predict the risk of IR in patients with PCOS.
本研究旨在探讨腰高比（WHtR）在评估多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）中的作用。
我们纳入了882名患有PCOS的女性进行横断面分析，以评估WHtR与IR之间的关联。收集并测量了她们的人口统计学特征、人体测量参数和空腹血样。此外，通过胰岛素抵抗稳态模型评估（HOMA-IR）来评估IR。我们分别使用多变量线性回归和逻辑回归模型估计WHtR与IR之间的关系以及IR的WHtR截断阈值。
IR的患病率为51.9%。患有PCOS和IR的患者的体重指数（BMI）、腰围（WC）、WHtR、收缩压（SBP）、舒张压（DBP）、游离雄激素指数（FAI）、HOMA-IR、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和载脂蛋白B（ApoB）值显著升高。然而，患有PCOS和IR的患者的雌二醇（E2）、促黄体生成素（LH）、LH/FSH比值、性激素结合球蛋白（SHBG）和高密度脂蛋白（HDL-C）值比没有IR的患者降低。此外，BMI（对数转换）、WC和HOMA-IR（对数转换）与WHtR呈正相关。在调整潜在混杂变量后，WHtR与HOMA-IR（对数转换）显著相关，标准化回归系数为0.271。此外，WHtR与IR风险增加显著相关，调整后的优势比（OR）为3.15（WHtR乘以10）。此外，WHtR有助于识别PCOS女性中的IR，最佳截断点为0.519（约登指数 = 0.433）。
WHtR与PCOS女性的IR呈正相关。因此，我们建议WHtR作为一种简单、实用且可靠的人体测量指标，可用于预测PCOS患者的IR风险。
