Determination of insulin resistance and its relationship with hyperandrogenemia,anti-Müllerian hormone, inhibin A, inhibin B, and insulin-like peptide-3 levels in adolescent girls with polycystic ovary syndrome

Abstract

Background/aim: This study aims to investigate the association between polycystic ovary syndrome (PCOS) and obesity and insulin resistance (IR) with respect to anti-Müllerian hormone (AMH), inhibin A (INH-A), inhibin B (INH-B), and insulin-like peptide 3 (INSL3) levels, all factors which may have an impact on IR. Materials and methods: In this cross sectional study, 52 adolescent girls diagnosed with PCOS [groups: nonobese (NO), n = 23; overweight/obese (OW/O), n = 29] were included. Blood samples were obtained to measure AMH, INH-B, INH-A, and INSL3 levels, together with hormonal and biochemical assessments. Oral glucose tolerance test (OGTT) was performed and the indexes of IR [homeostasis model assessment: insulin resistance (HOMA-IR) and Matsuda index] were calculated. Results: Insulin resistance was 56.5% with OGTT and 30.4% with HOMA-IR in nonobese-PCOS girls. There was a correlation between INH-A and HOMA-IR even when controlled for body mass index (BMI). INH-B and FAI also had correlations with HOMA-IR which disappeared when controlled for BMI. In regression analyses, AMH (odds ratio = [0.903, P = 0.015) and FAI (odds ratio = 1.353, P = 0.023) are found to be contributors to IR. Their effect was BMI-independent. In ROC analysis, the cutoff value for FAI was 5.93 (sensitivity 71%) to define IR in PCOS girls. Conclusion: AMH and FAI may contribute to IR (defined by OGTT) in PCOS. FAI might be used as a supporting IR marker (defined by OGTT) in adolescent girls with PCOS.

Polycystic Ovary Syndrome in Insulin-Resistant Adolescents with Obesity: The Role of Nutrition Therapy and Food Supplements as a Strategy to Protect Fertility

“…Numerous studies proved that women and adolescents with PCOS and obesity have more pronounced signs of hyperandrogenism and insulin resistance; higher BMI values positively correlated with free androgen index (FAI), total testosterone, free testosterone, homeostatic model assessment for insulin resistance (HOMA-IR), fasting insulin, fasting glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglyceridemia, estradiol (E2) and androstenedione but negatively correlated with circulating levels of sex-hormone-binding globulin (SHBG), inhibin B and high-density lipoprotein cholesterol (HDL-C) [51,52]. Obese and overweight adolescents with PCOS also presented a higher frequency of hirsutism and acanthosis nigricans [53].…”

Association between insulin resistance and abnormal menstrual cycle in Chinese patients with polycystic ovary syndrome

“…It increases significantly in patients with PCOS and correlates with the severity of the disease, including oligomenorrhoea, and amenorrhea [ 46 , 47 ]. Some studies considered that the level of AMH was not significantly correlated with IR [ 48 ]; while other studies have shown that AMH level was negatively correlated with HOMA-IR index [ 14 , 15 ]. The association between AMH and IR does not have a clear description and needs to be elucidated by further studies.…”

“…Many factors influenced the secretion of INHB, such as FSH and insulin-like growth factor. However, few studies have shown the relationship between INHB and IR [ 14 , 15 ], which need to be further studied and explored. In this study we found that IR is significantly associated with INHB and progesterone ( P = 0.040 and 0.029, respectively).…”

“…In addition to sex hormones, both Anti-Müllerian hormone (AMH) and inhibin B (INHB) are secreted by ovarian granulosa cells, and both are affected when patients experience disruptions in their menstrual cycle. Some studies have shown that AMH and INHB are negatively correlated with HOMA-IR [ 14 , 15 ].…”

Evaluation of Serum AMH, INHB Combined with Basic FSH on Ovarian Reserve Function after Laparoscopic Ovarian Endometriosis Cystectomy

“…Therefore, the evaluation of ovarian reserve function after ovarian cyst debulking using serum bFSH alone has the problem of poor specificity and sensitivity. Both Serum AMH and INHB belong to the transforming growth factor-β superfamily, and both serum levels are positively correlated with ovarian responsiveness and follicle number, both of which can be used to assess ovarian reserve function ( 19 , 20 ). The results of this study found that the AUC of serum AMH, INHB, bFSH and the combination of the three for abnormal ovarian reserve after ovarian cystectomy were 0.866, 0.810, 0.774, and 0.940, respectively, which indicated that compared with serum bFSH, INHB and AMH alone for predicting ovarian reserve function after ovarian cyst debulking, the combined test significantly improve the detection rate of abnormal postoperative ovarian reserve function.…”