How Significant are Insulin Resistance Parameters in Subjects with Polycystic Ovarian Syndrome (PCOS)? A Cross-Sectional Study


  • Sikandar Hayat Khan Department of Radiology, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
  • Rahat Shahid Department of Radiology, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
  • Sohail Aslam Department of ENT, Pakistan Navy Station Shifa, Karachi Pakistan
  • Robina Manzoor Department of Gynae, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
  • Roomana Anwar Department of Biochemistry, Islamabad Medical & Dental College, Islamabad Pakistan
  • Tariq Chaudhry Department of Radiology, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan



Cardiovascular Disease (CVD), Free Androgen Index (FAI), Homeostasis model assessment for insulin resistance (HOMA-IR), Dihydrotestosterone


Objective: To evaluate insulin resistance by “Homeostasis Model Assessment for Insulin Resistance (HOMA IR)” and related
cardiovascular disease risks in females with or without polycystic ovarian syndrome.

Study Design Comparative cross-sectional study.

Place and Duration of Study: Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan, from Jan 2018 to Dec 2019.
Methodology: Patients diagnosed to have polycystic ovarian syndrome (n=158) as per Rotterdam criteria were compared with non-PCOS patients (n=162) for HOMA IR and other CVD risks. Measurement of glucose, insulin, lipid parameters and HbA1c for all subjects was carried out in fasting. PCOS was diagnosed by “Rotterdam Criteria”. Free Androgen Index was measured as FAI=(Total testosterone/SHBG) x100. Differences in insulin resistance among polycystic ovarian syndrome and nonpolycystic ovarian syndrome females were measured by the non-parametric test.

Results: Our study included 158 females (49.38%) with PCOS defined as per Rotterdam criteria, while 162 subjects did not
have PCOS (50.62%). The differences between PCOS and non-PCOS were LH: 5.15±3.66 vs. 4.58±2.87 IU/L (p=0.121), FSH:
5.87±3.57 vs. 7.26±4.63 IU/L (0.003), total testosterone: 1.76±0.86 vs. 1.17±0.45 nmol/L (<0.001) and SHBG: 41.59±31.94 vs.
55.50±34.76 (p<0.001). Insulin resistance was higher in PCOS [(3.81±3.58, n=156) in comparison to non-PCOS (3.11±2.49,
n=162), p=0.091]. Both the presence of PCOS and obesity, as measured by BMI, were associated with higher HOMA-IR.

Conclusion: Insulin resistance was found to be higher in PCOS females than in non-PCOS females. BMI also contributed to
higher insulin resistance among our study population.


Download data is not yet available.


Metrics Loading ...


Kotake H, Oikawa S. Syndrome X. Nihon Rinsho 1999; 57(3):


Gluvic Z, Zaric B, Resanovic I, Resanovic I, Obradovic

M, Mitrovic A, et al. Link between Metabolic Syndrome and

Insulin Resistance. Curr Vasc Pharmacol 2017; 15(1): 30–39.

Nolan CJ, Prentki M. Insulin resistance and insulin

hypersecretion in the metabolic syndrome and type 2 diabetes:

Time for a conceptual framework shift. Diab Vasc Dis Res 2019;

(2): 118–127.

Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al.

Polycystic ovary syndrome. Nat Rev Dis Primers 2016; 2: 16057.

Dewailly D. Diagnostic criteria for PCOS: Is there a need for a

rethink? Best Pract Res Clin Obstet Gynaecol 2016; 37: 5–11.

Coutinho EA, Kauffman AS. The Role of the Brain in the

Pathogenesis and Physiology of Polycystic Ovary Syndrome

(PCOS). Med Sci (Basel) 2019; 7(8): 84.

Azziz R, Kintziger K, Li R, Laven J, Morin-Papunen L, Merkin

SS. Recommendations for epidemiologic and phenotypic

research in polycystic ovary syndrome: an androgen excess and

PCOS society resource. Hum Reprod 2019; 34(11): 2254–2265.

Bannigida DM, Shivananda Nayak B, Vijayaraghavan R. Insulin

resistance and oxidative marker in women with PCOS. Arch

Physiol Biochem 2018: 1-4.

Elhassan YS, Idkowiak J, Smith K, Asia M, Helena Gleeson

H, Webster R, et al. Causes, Patterns, and Severity of Androgen

Excess in 1205 Consecutively Recruited Women. J Clin

Endocrinol Metab 2018; 103(3): 1214–1223.

Wang F, Zhang ZH, Xiao KZ, Wang ZC. Roles of HypothalamicPituitary-Adrenal Axis and Hypothalamus-Pituitary-Ovary Axis in the Abnormal Endocrine Functions in Patients with Polycystic

Ovary Syndrome. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2017;

(5): 699–704.

Mezzullo M, Fanelli F, Di Dalmazi G, Fazzini A, Ibarra-Gasparini

D, Mastroroberto M, et al. Salivary cortisol and cortisone

responses to short-term psychological stress challenge in late

adolescent and young women with different hyperandrogenic

states. Psychoneuroendocrinology 2018; 91: 31-40.

Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The

prevalence of polycystic ovary syndrome in reproductive-aged

women of different ethnicity: a systematic review and metaanalysis. Oncotarget 2017; 8(56): 96351–96358.

Kollmann M, Klaritsch P, Martins WP, Guenther F, Schneider V,

Herzog SA, et al. Maternal and neonatal outcomes in pregnant

women with PCOS: comparison of different diagnostic

definitions. Hum Reprod 2015; 30(10): 2396-403.

Goodman NF, Bledsoe MB, Cobin RH, Futterweit W, Goldzieher

JW, Petak SM, et al; American Association of Clinical

Endocrinologists Hyperandrogenic Disorders Task Force.

American Association of Clinical Endocrinologists medical

guidelines for the clinical practice for the diagnosis and

treatment of hyperandrogenic disorders. Endocr Pract 2001; 7(2):


de Onis M, Habicht JP. Anthropometric reference data for

international use: recommendations from a World Health

Organization Expert Committee. Am J Clin Nutr 1996; 64(4): 650–

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF,

Turner RC. Homeostasis model assessment: insulin resistance

and beta-cell function from fasting plasma glucose and insulin

concentrations in man. Diabetologia 1985; 28: 412–419.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus

Workshop Group. Revised 2003 consensus on diagnostic criteria

and long-term health risks related to polycystic ovary syndrome.

Fertil Steril 2004; 81(1): 19-25.

Bui HN, Sluss PM, Hayes FJ, Knol LD, Blankenstein

AM, Heijboer CA. Testosterone, free testosterone, and free

androgen index in women: Reference intervals, biological

variation, and diagnostic value in polycystic ovary syndrome.

Clin Chim Acta 2015; 450: 227–232. 10.1016/j.cca.2015.08.019.

Belani M, Deo A, Shah P, Banker M, Singal P, Gupta S.

Differential insulin and steroidogenic signaling in insulin

resistant and non-insulin resistant human luteinized granulosa

cells-A study in PCOS patients. J Steroid Biochem Mol Biol 2018;

: 283-292. 10.1016/j.jsbmb.2018.01.008.

Aye MM, Butler AE, Kilpatrick ES, Kirk R, Vince R, Rigby AS, et

al. Dynamic Change in Insulin Resistance Induced by Free Fatty

Acids Is Unchanged Though Insulin Sensitivity Improves

Following Endurance Exercise in PCOS. Front Endocrinol

(Lausanne) 2018; 9: 592. 10.3389/fendo.2018.00592.

Coutinho EA, Kauffman AS. The Role of the Brain in the

Pathogenesis and Physiology of Polycystic Ovary Syndrome

(PCOS). Med Sci (Basel) 2019; 7(8): 84. 10.3390/medsci7080084.

Esparza LA, Schafer D, Ho BS, Thackray VG, Kauffman AS.

Hyperactive LH Pulses and Elevated Kisspeptin and NKB Gene

Expression in the Arcuate Nucleus of a PCOS Mouse Model.

Endocrinology 2020; 161(4): bqaa018. 10.1210/endocr/bqaa018.

Engmann L, Jin S, Sun F, Legro RS, Polotsky AJ, Hansen KR, et

al. Racial and ethnic differences in the polycystic ovary

syndrome metabolic phenotype. Am J Obstet Gynecol 2017;

(5): 493.e1-493.e13.




How to Cite

Khan, S. H., Shahid, R., Aslam, S., Manzoor, R., Anwar, R., & Chaudhry, T. (2024). How Significant are Insulin Resistance Parameters in Subjects with Polycystic Ovarian Syndrome (PCOS)? A Cross-Sectional Study. Pakistan Armed Forces Medical Journal, 74(1), 36–40.



Original Articles

Most read articles by the same author(s)

1 2 > >>