TITLE:
Insulin Resistance and Its Associated Risk Factors in Nigerian Women with Polycystic Ovary Syndrome
AUTHORS:
Chinyere B. N. Akpata, Patrick O. Uadia, Friday E. Okonofua
KEYWORDS:
Impaired Glucose Tolerance, Insulin Resistance, Nigerian Women, Polycystic Ovary Syndrome, Risk Factors
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.3,
March
18,
2019
ABSTRACT: Background: The etiology of polycystic ovary syndrome (PCOS) is not completely
understood; however one condition that correlates closely with the pathogenesis
of PCOS is insulin resistance (IR). The objective of this study was to
determine the prevalence of insulin resistance (IR) and the association of such
abnormality with potential risk factors in women with PCOS. Method: 116
women with confirmed PCOS attending a reproductive clinic at the University of
Benin Teaching Hospital in Benin City were studied. IR was determined by
homeostatic model assessment (HOMA) ≥ 2 and pre-diabetes by fasting plasma
glucose between 110 and 125 mg/dl and/or plasma glucose value between 140 and
200 mg/dl at 2 hours during an oral glucose tolerance test (OGTT) after
ingestion of 75 g oral glucose load. Results: Forty-two women were
insulin resistant among the 116 women with PCOS. The prevalence of IR was 36.2%
(95% CI 26.6 - 46.2). The prevalence of impaired fasting glucose (IFG) showed
1.7% (95% CI 0.97 - 2.03), impaired glucose tolerance (IGT) was 2.6% (95% CI
1.97 - 3.03) and diabetes mellitus (DM) was 1.7% (95% CI 0.97 - 2.03) in the
116 PCOS women. Of these 42 insulin resistant PCOS women, 23.8% (n = 10) were
obese and 40.5% (n = 17) were overweight. Multivariate analysis revealed that
total cholesterol (OR, 1.07; 95% CI, 1.04 - 1.10), triglycerides (OR, 1.08; 95%
CI, 1.04 - 1.13) and LDL-cholesterol (OR, 1.08; 95% CI, 1.04 - 1.12) were
statistically significant independent risk factors for IR. Conclusion: The
prevalence of IR was high in women with PCOS, and there was a significant
association between IR, obesity, and dyslipidemia. However, the prevalence
rates of impaired glucose tolerance and DM were low in women with PCOS compared
to other studies. Since women with PCOS are at risk of IR and dyslipidemia,
early screening, detection, intervention, and lifestyle modification would
ameliorate the financial burden of DM and cardiovascular disease (CVD).