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Hum. Reprod. Advance Access published online on September 25, 2007
Human Reproduction, doi:10.1093/humrep/dem302
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome

Pilar Vigil1,2,4, Patricio Contreras2, Jorge L. Alvarado3, Ana Godoy1,2, Ana M. Salgado2 and Manuel E. Cortés1

1 Unidad de Reproducción y Desarrollo, Departamento de Ciencias Fisiológicas, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Alameda B. O’Higgins 340, Santiago, Chile 2 Fundación Médica San Cristóbal, Luis Pasteur 5292, Vitacura, Santiago, Chile 3 Departamento de Ecología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Alameda B. O’Higgins 340, Santiago, Chile

4 Correspondence address. Tel/Fax: +56-2-6862975; E-mail: pvigil{at}bio.puc.cl

BACKGROUND: Polycystic ovary syndrome (PCOS) is non-uniformly associated with insulin resistance (IR). We examined IR in women with PCOS.

METHODS: Sixty-nine PCOS women were subjected to the insulin suppression test (IST) to determine their steady-state plasma glucose (SSPG) as a direct measure of insulin sensitivity.

RESULTS: SSPG exhibited a multimodal distribution suggesting the existence of subpopulations. The heterogeneous distribution of plasma glucose at 180 min (P = 0.011), with three modes, suggested differences in the plasma glucose level trajectories during the IST. Hence, the population was separated into three groups: (i) (n = 33), subjects with SSPG ≤ 152.5 mg/dl, corresponding to the first to fifth deciles; (ii) (n = 29), subjects in the interval 152.5 mg/dl < SSPG ≤ 300 mg/dl; (iii) (n = 7), subjects with SSPG > 300 mg/dl, corresponding to the tenth decile. Plasma glucose distributions at 180 min showed differences in their mean values and ranges among groups (P < 0.0001). The trajectories of the groups differed significantly during the IST (P < 0.0001).

CONCLUSIONS: insulin sensitivity in our patients exhibited a discontinuous distribution, implying that PCOS is a heterogeneous disorder possessing subpopulations regarding IR.

Key words: hyperandrogenism/insulin resistance/insulin suppression test/polycystic ovary syndrome/subpopulations

Submitted on April 11, 2007; resubmitted on August 6, 2007; accepted on August 24, 2007.


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