Yonsei Med J.  2015 May;56(3):785-792. 10.3349/ymj.2015.56.3.785.

Triglyceride Is a Useful Surrogate Marker for Insulin Resistance in Korean Women with Polycystic Ovary Syndrome

• Park SY
• Cho YJ
• Lee SR
• Chung H
• Jeong K

• KMID: 2450354
• DOI: http://doi.org/10.3349/ymj.2015.56.3.785

Abstract

PURPOSE
To evaluate lipid profiles and liver enzymes as surrogate markers used for recognizing insulin resistance in Korean women with polycystic ovary syndrome (PCOS).
MATERIALS AND METHODS
458 women with PCOS were divided into two groups: non-obese with a body mass index (BMI)<25.0 kg/m2 and obese with a BMI> or =25.0 kg/m2. Anthropometric measures and blood sampling for hormone assay, liver enzymes, lipid profiles and 75 g oral glucose tolerance test were performed. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR)> or =2.5. Areas under the receiver operating characteristic (ROC) curves were used to compare the power of serum markers. Multiple linear regression analysis was used to evaluate the contribution of each confounding factor for HOMA-IR.
RESULTS
In non-obese and obese groups, the ROC curve analyses demonstrated that the best marker for insulin resistance was triglyceride (TG), with the areas under the ROC curve of 0.617 and 0.837, respectively. Low-density lipoprotein cholesterol (LDL-C) was the significant marker for insulin resistance with areas under the ROC curve of 0.698 in obese group, but not significant in non-obese group. TG and LDL-C were significantly associated with HOMA-IR in both non-obese and obese PCOS women by multiple linear regression analysis. The optimal cut-off points of TG> or =68.5 was a marker for predicting insulin resistance in non-obese PCOS patients and TG> or =100.5 in obese group.
CONCLUSION
TG can be used as a useful marker for insulin resistance in Korean women with PCOS, especially for obese patients.

Keyword

Triglyceride; insulin resistance; polycystic ovary syndrome

MeSH Terms

Adult
Asian Continental Ancestry Group/ethnology
Biological Markers/blood
Body Mass Index
Cholesterol, LDL/blood
Female
Glucose Tolerance Test
Humans
Insulin/blood
Insulin Resistance/ethnology/*physiology
Lipids/blood
Obesity/*blood/ethnology
Polycystic Ovary Syndrome/*blood/ethnology
ROC Curve
Regression Analysis
Republic of Korea/epidemiology
Triglycerides/*blood
Biological Markers
Cholesterol, LDL
Insulin
Lipids
Triglycerides

Figure

• 

  Fig. 1 Receiver operating characteristics (ROC) curves. Sensitivity represents the true-positive results and 1-specificity, the false-positive results. The best markers have ROC curves that are shifted to the left with areas under the curve near unity. Non-diagnostic markers are represented by diagnosis with areas under the ROC curves close to 0.5. AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDL-C, low-density lipoprotein cholesterol; hs-CRP, high sensitivity C-reactive protein; HDL-C, high-density lipoprotein cholesterol.

• 

  Fig. 2 Correlation between TG and HOMA-IR categorized by BMI. Data for HOMA-IR and TG were skewed and log-transformed for analysis. The lines of best fit (BMI<25.0 kg/m2: r2=0.095, p<0.001; BMI≥25.0 kg/m2: r2=0.336, p<0.001) are indicated. BMI, body mass index; HOMA-IR, homeostasis model assessment of insulin resistance; TG, triglyceride.

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