Published: 2017-01-09

Polycystic ovarian syndrome and insulin resistance: a North Indian study

Nitin Agarwal, Sukanya Gangopadhyay, Nirensingh Koch, Akash Gupta, Aruna Batra, B. C. Kabi


Background: Polycystic ovarian syndrome (PCOS) is most common form of chronic anovulation associated with androgen excess. Insulin resistance (IR) is characterized by impaired glucose response to specific amount of insulin. The objective of the study was to find an association between PCOS and IR in North Indian patients.

Methods: A total of 50 PCOS cases diagnosed according to Rotterdam criteria, 2003, i.e. at least two of the following three features: oligomenorrhea or amenorrhea, clinical or biochemical hyperandrogenism and polycystic ovaries on ultrasound. Serum glucose levels were measured spectrophotometrically by glucose oxidase-peroxidase method. Insulin levels in serum were estimated by using ELISA based kit procured form Diasorin Ltd, Germany. Homeostatic Model Assessment- Insulin Resistance (HOMA-IR) and Body Mass Index (BMI) were calculated by their formulas.

Results: PCOS patients had significantly higher values of BMI, fasting serum glucose, fasting serum insulin and HOMA-IR. Fasting serum glucose was however in the normal range in both cases and control.

Conclusion: Our study suggested a strong association of PCOS with insulin resistance in this part of the country.



Polycystic ovarian syndrome, Insulin resistance, Type II diabetes mellitus, HOMA-IR

Full Text:



Melmed S, Polonsky KS, Laesen PR, Kornenberg HM. Williams Textbook of Endocrinology. 12th ed. Philadelphia: Saunders; 2012. pp 622.

Dunaif A. Insulin resistance and polycystic ovary syndrome: mechanism and implication for pathogenesis. Endo Rev. 1997;18(6):774-800.

Stein I, Levinthal M. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-191.

Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FR, Merriam GR (eds) Polycystic ovary syndrome, Oxford, England: Blackwell Scientific; 1992 pp, 377-384.

The Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group, Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1): 41-47.

Franks S. Polycystic ovary syndrome. N Engl J Med. 1995;333(13): 853-861.

Burghen GA, Givens JR, Kitabchi AE. Correlation of hyper androgenism with hyperinsulinemia in polycystic ovaries. J Clin Endocrinol Metabo. 1980;50(1):113-116.

Osei K, Schuster DP. Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabet Med. 1994;11(8):755-762.

Shoupe D, Kumar DD, Lobo RA. Insulin resistance in polycystic ovary syndrome. Am J Obstet Gynecol. 1983;147(5): 588-592.

Legro RS, Kunselman AR, Dodson W, Dunaif A. Prevalence and predictors of risk for type II diabetes mellitus and impaired glucose tolerance in PCOS: A prospective controlled study in 254 affected women. J Clin Endocrinol Metabo. 1999; 84(1):165-169.

Mather KJ, Kwan F, Corenblum B. Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity. Fertil Steril. 2000;73(1): 150-156.

Toprak S, Yonem A, Cakir B, Guler S, Azal O, Ozata M, et al. Insulin resistance in nonobese patients with polycystic ovary syndrome. Horm Res. 2001;55(2): 65-70.

Ehrmann DA, Liljenquist DR, Kasza K, Aziz R, Legro RS, Ghazzi MN. Prevelance and predictors of the metabolic syndrome in women with polycystic ovarian syndrome. J Clin Endocrinol Metbo. 2006; 91(1):48-53.

REA-SPCW Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner R. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7): 412–419.

Holte J, Bergh T, Berne C, Wide L, Lithell H. Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1995;80(9):2586-2593.

Dunaif A, Xia J, Book CB, Schenker E, Tang Z. Excessive insulin receptor serine phosphorylation in cultured fibroblasts and in skeletal muscle. A potential mechanism for insulin resistance in the polycystic ovary syndrome. J Clin Invest. 1995;96(2): 801-810.

Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38(9): 1165-1174.

Robinson S, Kiddy D, Gelding SV, Willis D, Niththyananthan R, Bush A, et al. The relationship of insulin insensitivity to menstrual pattern in women with hyperandrogenism and polycystic ovaries. Clin Endocrinol. 1993;39(3): 351-355.

Abbott DH, Dumesic DA, Franks S. Developmental origin of polycystic ovary syndrome - a hypothesis. J Endocrinol. 2002;174(1):1-5.

Dahlgren E, Johansson S, Lindstedt G, Knutson F, Oden A, Janson PO et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril. 1992;57(1): 505-513.

Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22(1):141-146.

Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84(1): 165-169.

Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol. 2000;52(5): 595-600.

Weerakiet S, Srisombut C, Bunnag P, Sangtong S, Chuangsoongnoen N, Rojanasakul A. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome. Int J Gynaecol Obstet. 2001;75(2): 177-184.

Gambineri A, Pelusi C, Manicardi E, Vicennati V, Cacciari M, Morcelli-Labate AM et al. Glucose intolerance in a large cohort of Mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Diabetes. 2004;53(9): 2353-2358.

Harris MI, Hadden WC, Knowler WC, Bennett PH. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20-74 yr. Diabetes. 1987; 36(4): 523-534.

King H, Rewers M. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care. 1993;16(1): 57-77.

Norman RJ, Masters S, Hague W. Hyperinsulinemia is common in family members of women with polycystic ovary syndrome. Fertil Steril. 1996; 66(6): 942-947.