IntroductionThe study aimed to estimate the cut-off value for homeostatic model assessment for insulin resistance (HOMA-IR) discriminating the insulin resistance based on the sex hormones binding globulin (SHBG) level in women with polycystic ovary syndrome (PCOS).Materials and methodsData from medical records of 854 Caucasian women diagnosed with PCOS were analyzed. Anthropometric data, fasting plasma glucose, insulin and SHBG levels were measured. HOMA-IR was calculated with a standard formula. The cut-off value was calculated using receiver-operating characteristics.ResultsCirculating SHBG levels below the normal range (26.1 nmol/L) were found in 25.4% of study participants. This subgroup had a significantly higher BMI, fasting glucose and insulin concentrations and HOMA-IR values. Empirical optimal cut-off values for HOMA-IR corresponding to low SHBG levels was ≥2.1 [area under the curve (AUC) 0.73, accuracy 0.65, sensitivity 72.3%, specificity 63.1%, positive predictive value (PPV) 40.0%, negative predictive value (NPV) 87.0%].ConclusionsOur study suggests that the cut-off point for HOMA-IR discriminating the insulin resistance based on the SHBG level, in young Caucasian women with polycystic ovary syndrome is 2.1, and is consistent with the cut-off value adopted by the European Group for the Study of Insulin Resistance (above 2.0).

Każdego roku choroby układu krążenia powodują ponad 4 mln zgonów w społeczeństwach 53 krajów europejskiego regionu WHO, z czego 1,9 mln przypada na kraje zrzeszone w Unii Europejskiej. Organizacja Współpracy Gospodarczej i Rozwoju (OECD) podaje, że w 2010 r. 13% zgonów w krajach Unii Europejskiej było następstwem choroby wieńcowej. Celem pracy jest analiza czynników społeczno-ekonomicznych ponoszonych w związku z chorobami układu krążenia oraz zasobów i nakładów przeznaczanych na finansowanie systemu ochrony zdrowia w Polsce i wybranych krajach Europy Środkowej.