Length of menstrual cycle predicts severity of insulin resistance in women with PCOS: Study
China: Menstrual disturbance reflected by the interval between episodes of vaginal bleeding may predict the severity of insulin resistance (IR) in women with polycystic ovary syndrome (PCOS), says a recent study published in Frontiers in Endocrinology.
A higher degree of disturbance in menstrual cyclicity in women with polycystic ovary syndrome increased the LH/FSH ratio, the severity of insulin resistance (IR), and androgen level, the study noted. Subgroup analysis showed that the situation of hyperandrogenism (HA) in women with PCOS may aggravate the disorder of glucose metabolism.
Insulin resistance is an important determinant of the morbidity and phenotype of PCOS. In a cross-sectional study, Xiaojia Li, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, and colleagues aimed to examine the association between the degree of menstrual disturbance and IR severity in women with PCOS.
The study included five hundred twenty-seven women diagnosed with PCOS by the 2003 Rotterdam criteria and 565 controls with regular vaginal bleeding. The interventions done for this study are medical history collection, blood sampling, and physical examination.
The main outcome measures included body mass index (BMI), fasting insulin, fasting glucose, homeostatic model assessment for IR (HOMA-IR), and hormonal parameters.
The researchers reported the following findings:
- Women with PCOS had a higher level of BMI, HOMA-IR, and HOMA-β than controls, with a decreased level of sex hormone-binding globulin and QUICK I index.
- The luteinizing hormone (LH)/follicle-stimulating hormone (FSH), testosterone (T), antral follicle count (AFC), dehydroepiandrosterone sulfate, free androgen index, modified Ferriman-Gallwey score, and the incidence of delayed insulin peak increased with the degree of menstrual disturbance, although there was no significance for the latter four parameters.
- Women with vaginal bleeding intervals of 45-90 days had a relatively higher level of HOMA-IR and HOMA-β, although it was adjusted with age and BMI than the other two groups. Similar results were observed in AUCI (area under the curve of insulin) and I/G [the ratio of AUCI and AUCG (area under the curve of glucose)].
- Anovulatory women with vaginal bleeding episodes of less than 45 days tended to have higher glucose and insulin levels, area under the curve of glucose (AUCG), area under the curve of insulin (AUCI), HOMA-IR, and HOMA-β but decreased QUICK I and Matsuda index than those who were ovulatory.
- Women with vaginal bleeding intervals of longer than 45 days who had hyperandrogenism (HA) showed a higher level of glucose, insulin, HOMA-IR, and HOMA-β but lower QUICK I and Matsuda Index.
The researchers wrote in their conclusion, "we found that the abnormality of androgen metabolism in women with PCOS changed with the severity of oligomenorrhea, and the severity of IR in women with PCOS is positively correlated with the vaginal bleeding interval."
"The menstrual disturbance reflected by the length of a menstrual cycle may effectively predict IR in women with PCOS," the researchers wrote in their study.
Reference:
Li, Xiaojia, et al. "The Degree of Menstrual Disturbance Is Associated With the Severity of Insulin Resistance in PCOS." Frontiers in Endocrinology, vol. 13, 2022, p. 873726.
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