Although there is a widespread on-going debate throughout the scientific community with regard to the pathogenesis of polycystic ovary syndrome, the association between this frequently observed endocrine disorder and insulin resistance has been universally acknowledged. Numerous tests have been proposed for use in assessing reduced sensitivity to insulin in women with polycystic ovary syndrome. The gold standard is represented by the euglycemic hyperinsulinemic clamp, although not yet available for application in routine clinical practice in view of its complexity and high cost. Measurement of oral glucose load and the use of several fasting tests feature a good degree of reliability and can be easily repeated. It remains to be ascertained, however, which therapeutic procedures, if any, are best suited for use in women affected by hyperinsulemia. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After reading this article, the reader should be able to outline metabolic consequences of polycystic ovarian syndrome (PCOS), conclude that testing insulin resistance is an important step in the care of women with PCOS, and recall the indications and limits of testing strategies for insulin resistance.
Diagnosis of metabolic disorders in women with polycystic ovary syndrome
MELIS, GIAN BENEDETTO;FULGHESU, ANNA MARIA
2008-01-01
Abstract
Although there is a widespread on-going debate throughout the scientific community with regard to the pathogenesis of polycystic ovary syndrome, the association between this frequently observed endocrine disorder and insulin resistance has been universally acknowledged. Numerous tests have been proposed for use in assessing reduced sensitivity to insulin in women with polycystic ovary syndrome. The gold standard is represented by the euglycemic hyperinsulinemic clamp, although not yet available for application in routine clinical practice in view of its complexity and high cost. Measurement of oral glucose load and the use of several fasting tests feature a good degree of reliability and can be easily repeated. It remains to be ascertained, however, which therapeutic procedures, if any, are best suited for use in women affected by hyperinsulemia. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After reading this article, the reader should be able to outline metabolic consequences of polycystic ovarian syndrome (PCOS), conclude that testing insulin resistance is an important step in the care of women with PCOS, and recall the indications and limits of testing strategies for insulin resistance.
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