Rapid and easy assessment of insulin resistance contributes to early detection of polycystic ovary syndrome

Aims: Polycystic ovary syndrome (PCOS) is frequently observed in women of reproductive age, and is associated with disturbances in both reproductive and metabolic function. Insulin resistance (IR) is key to the pathophysiology of PCOS, and early detection may improve outcomes in this patient group. Rapid and straightforward laboratory tests may contribute towards early detection. Methods: A retrospective chart review of 185 women presenting for the first time to a gynecology clinic was carried out. Of this group, 77 met the inclusion criteria. The sample was divided according to insulin sensitivity (IS) given by the Matsuda Index, and the two groups were compared using correlation analysis. Furthermore, the sensitivity and specificity of the Matsuda, homeostasis model assessment of IR (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) indexes were compared. Results: Although bodu mass index (BMI) was higher in the insulin resistant group than the insulin sensitive group, the mean age of the IR group was actually lower. HOMA-IR and QUICKI correlated well with the Matsuda index in both groups. The HOMA-IR test showed the highest sensitivity and specificity in the detection of IR when compared to the Matsuda Index, and no added benefit was derived from using a combination of both QUICKI and HOMA- 1R. Conclusions: In a group of 77 women diagnosed with PCOS, 49 (63.6%) had IR according to the Matsuda index. The HOMA-IR index, which is based on fasting serum insulin and glucose, correlated closely with the Matsuda index, indicating it may be a reliable substitute in the detection and subsequent early intervention required to improve outcomes in PCOS