Indexes of Insulin Resistance in Hyperinsulinemic Polycystic Ovary Syndrome in a Macedonian Cohort of Women of Reproductive Age: A Cross-Sectional Study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is complex hormonal, metabolic and reproductive disorder and is a leading cause of female infertility. Hyperinsulinemia secondary to insulin resistance plays important role in the pathogenesis of PCOS. AIM: To assess the sensitivity of different indices of insulin resistance and their relevance in a clinical setting. MATERIAL AND METHODS: A cross-sectional study of 43 patients with PCOS and 29 noromo ovulatory women as a control group was conducted. Standard clinical, anthropometrical and hormonal testing for hyperandrogenism was conducted, as well as oral glucose tolerance test with determination of basal and stimulated glucose and insulin values. RESULTS: The dynamic I/G index showed the highest sensitivity and specificity, but the static indexes HOMA-IR and QUICKI, although based on only basal glycemic and insulinemic values, showed good sensitivity, 90.38% and 94.01% respectively. HOMA-IR showed significant positive correlation with the stimulated insulin values. CONCLUSIONS: Our results support the use of static indexes in the evaluation of insulin resistance in women with PCOS in a clinical setting, offering a simple assessment of insulin resistance in PCOS, which holds great prognostic and treatment implications.

Clinical role of estimation metabolic syndrome's components in type 2 diabetic population with symptomatic coronary artery disease--a comparison of two criteria.

Objective of our study was to estimate the metabolic syndrome (MSy)' components in type 2 diabetic subjects (T2D) with symptomatic coronary artery disease (CAD): arterial hypertension, waist circumference, triglyceridemia and plasma level of HDL, in order to define their clinical role in angina severity status. Second objective was to compare Adult Treatment Panel (ATP III) and International Diabetes Federation (IDF) criteria in testing of association MSy with current coronary status of population. Three hundred and twenty seven pts with T2D and manifested CAD were randomly included in a survey. Angina severity was assessed with the Canadian Cardiovascular Society (CCS). Data relieved MSyand its components, defined by ATP III, with predictive role for advanced angina stages. Presence of MSy is predictive for CCS3 angina severity (OR 9,93, 95% CI 0,78-126,28). Increased waist is a predictor for CCS3 (OR 1,22, 95% CI 0,27-5,46) and CCS4 symptoms onset (OR 1,55, 95% CI 0,36-6,73). CCS4 severity symptom is independently associated with arterial hypertension (OR 3,72, 95% CI 1,03-13,40) and hypertriglyceridemia (OR 1,72, 95% CI 0,42- 7,00). MSy components: increased waist, arterial hypertension and hypertriglyceridemia have been found predictive for angina CCS4 stage in T2D subjects, when IDF criteria were used. These findings raise the question of importance of metabolic syndrome and its individual constellations in T2D subjects with CAD. Results indicate that both criteria ATP III and IDF are reliable to define MSy in predictive model for coronary clinical status in T2D population.