Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome

Abstract

Background: The aim of the present study is to assess insulin resistance (IR) in women with hyperandrogenic syndrome, which was suggested to replace the term polycystic ovary syndrome by the Androgen Excess Society, and to evaluate whether sex hormone-binding globulin (SHBG) can be used as a predictive marker of IR in hyperandrogenic women. Methods: Clinical, metabolic, and endocrine parameters were measured, and an oral glucose tolerance test was carried out. The women were classified as IR group or non-IR group, in accordance with defined cutoff points for the homeostatic model assessment of IR (HOMA-IR) at R2.5, the quantitative insulin sensitivity check index at %0.33, and the Matsuda insulin sensitivity index (ISI) at %5. Results: The women classified as having IR had a significantly higher body mass index (BMI) and free androgen index (FAI) and showed significantly lower SHBG and high-density lipoprotein (HDL) levels, regardless of the indices used. However, with the Matsuda ISI, generally more women were diagnosed as having IR, and this group had significantly higher total testosterone and triglyceride values, as well as a higher incidence of hirsutism. Conclusions: Women who were classified as being insulin resistant using insulin sensitivity indices showed significantly higher BMI and FAI values and lower SHBG and HDL levels. However, the Matsuda ISI may be more favorable for identifying IR in hyperandrogenic women. SHBG may serve as a predictive marker of IR in these women, particularly in those who are obese.

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

“…G/I ratio correlated strongly with clampdemonstrated IR in a small study of PCOS women interestingly, both lean and obese PCOS women had evidence of IR. Sex hormone binding globulin (SHBG) did not correlate with IR in this study [47] , as has been previously postulated [53] . Quantitative insulin sensitivity check index (QUICKI) was developed to improve the sensitivity of fasting mea surements.…”

Body mass index and ovarian function are associated with endocrine and metabolic abnormalities in women with hyperandrogenic syndrome

“…Recently, SHBG was found to be a predictive marker of insulin resistance (34), which showed a significant negative correlation with the incidence of hirsutism, amenorrhea, and BMI R25 kg/m 2 and was also significantly altered in patients with amenorrhea or BMI R25 kg/m 2 . Diagnosing insulin resistance in women with hyperandrogenemic syndrome or androgen excess may help identify endocrine and metabolic risk factors and identify individuals for targeted treatment with insulin sensitizers, in order to improve treatment approaches and prevent complications later in life (35,36).…”

Is anti-Mullerian hormone an indicator of potential polycystic ovary syndrome in prepubertal girls with simple obesity?

“…AMH was studied with the Immunotech/Beckman Coulter instrument using the Elisa method. HOMA-IR calculations used the following formula: Fasting glucose (FG; mmol/l) x fasting insulin (FI; mcU/ml)/ 22.5 13 .…”