Triglyceride-Glucose Index as A Crucial Marker for Polycystic Ovary Syndrome Women with Insulin Resistance

Andon Hestiantoro, Jaya Saraswati, David Eka Prasetya, Ferry Sandra, Raden Muharam, Gita Pratama, Achmad Kemal Harzif

Abstract


BACKGROUND: Insulin resistance (IR) is considered as the main driver of polycystic ovary syndrome (PCOS) pathogenesis. In PCOS condition, IR is frequently related to glucose, anthropometric profile, lipid profile, and hormone profile parameters. However, not all PCOS phenotype show IR. Therefore, this study was conducted to determine the association the parameters mentioned above in PCOS subjects with and without IR.

METHODS: Fifty PCOS women with IR and 26 PCOS women without IR were recruited. All subjects underwent physical examination for measurement of weight, waist circumference (WC), and body mass index (BMI). Ferriman Gallwey Score (FGS) was used to evaluate hirsutism. Blood sample was taken from each subject for measurement of fasting glucose, postprandial glucose, fasting insulin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, triglyceride (TG), sex hormone binding globulin (SHBG), thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), and prolactin. Homeostatic model assessment for IR (HOMA-IR), TG-glucose index (TyGI), and free testosterone index (FTI) were then calculated.

RESULTS: From all the parameters examined, only fasting insulin (p<0.001), HOMA-IR (p<0.001), SHBG (p=0.012), TG (p<0.001), and TyGI (p=0.008) that show significant differences between PCOS subjects with and without IR. After multivariate analysis, TyGI was found to have strong association with IR occurrence in PCOS subjects (p=0.005) with an odd ratio of 5.26 (1.65–16.74).

CONCLUSION: TyGI appears to have a significant association with the IR occurrence in PCOS subjects. Hence, it can be suggested that TyGI could be an important marker for PCOS women with IR.

KEYWORDS: insulin resistance, lipid metabolism, polycystic ovary syndrome, triglyceride-glucose index


Full Text:

PDF

References


Jonard S, Robert Y, Ardaens Y, Dewaily D. Ovarian histology, morphology, and ultrasonography in the polycystic ovary syndrome. In: Azziz R, Nestler J, Dewaily D, editors. Contemporary Endocrinology: Androgen Excess Disorders in Women: Polycystic Ovary Syndrome and Other Disorders. 2nd ed. Totowa: Humana Press Inc.; 2006, CrossRef.

Lewandowski KC, Plusajska J, Horzelski W, Lewinski A. Prevalence of dyslipidaemia and pre-diabetes among women with polycystic ovary syndrome (PCOS): Do we overestimate cardiovascular risk? Horm Metab Res. 2019; 51(8): 539-45, CrossRef.

Kartika R, Wibowo H. Impaired function of regulatory T cells in type 2 diabetes mellitus. Mol Cell Biomed Sci. 2020; 4(1): 1-9, CrossRef.

Limantara E, Kartawidjajaputra F, Suwanto A. Evaluation of potential gene expression as early markers of insulin resistance and non-alcoholic fatty liver disease in the Indonesian population. Indones J Biotechnol. 2018; 23(2): 84-90, CrossRef.

Anwar AA, Abdullah N, Padjalangi AN, Hamid F, Mappeware NA, Lukas E. Serum leptin concentration is correlated to insulin resistance in polycystic ovary syndrome (PCOS) patients. Mol Cell Biomed Sci. 2021; 5(2): 93-7, CrossRef.

Amisi CA. Markers of insulin resistance in polycystic ovary syndrome women: An update. World J Diabetes. 2022; 13(3): 129-49, CrossRef.

Marino L, Jornayvaz FR. Endocrine causes of nonalcoholic fatty liver disease. World J Gastroenterol. 2015; 21(39): 11053-76, CrossRef.

Kheirollahi A, Teimouri M, Karimi M, Vatannejad A, Moradi N, Borumandnia N, Sadeghi A. Evaluation of lipid ratios and triglyceride-glucose index as risk markers of insulin resistance in Iranian polycystic ovary syndrome women. Lipids Health Dis. 2020; 19(1): 235, CrossRef.

Bayuaji H, Nataprawira H, Sastramihardja H, Permadi W. The correlation of serum total testosterone, sex hormone binding globulin and free androgen index with athens insomnia scale score in polycystic ovary syndrome. Indones Biomed J. 2018; 10(1): 46-50, CrossRef.

Novianti ME, Bakri S, Arief M, Sandra F. Correlation between homeostatic model assessment-estimated insulin resistance (HOMA-IR) with asymmetric dimethylarginine (ADMA) in prehypertension. Indones Biomed J. 2013; 5(3): 169-72, CrossRef.

Kim JJ, Choi YM, Cho YM, Hong MA, Chae SJ, Hwang KR, et al. Polycystic ovary syndrome is not associated with polymorphisms of the TCF7L2, CDKAL1, HHEX, KCNJ11, FTO and SLC30A8 genes. Clin Endocrinol. 2012; 77(3): 439-45, CrossRef.

Xing C, Zhang J, Zhao H, He B. Effect of sex hormone-binding globulin on polycystic ovary syndrome: Mechanisms, Manifestations, genetics, and treatment. Int J Womens Health. 2022; 14: 91-105, CrossRef.

Kruszewska J, Laudy-Wiaderny H, Kunicki M. Review of novel potential insulin resistance biomarkers in pcos patients-the debate is still open. Int J Environ Res Public Health. 2022; 19(4): 2099, CrossRef.

Jaime J, Moenter SM. GnRH neuron excitability and action potential properties change with development but are not affected by prenatal androgen exposure. eNeuro. 2022; 9(6): ENEURO.0362-22.2022, CrossRef.

Duan C, Pei T, Li Y, Cao Q, Chen H, Fu J. Androgen levels in the fetal cord blood of children born to women with polycystic ovary syndrome: a meta-analysis. Reprod Biol Endocrinol. 2020; 18(1): 81, CrossRef.

Dilworth L, Facey A, Omoruyi F. Diabetes mellitus and its metabolic complications: the role of adipose tissues. Int J Modul Sci. 2021; 22(4): 7644, CrossRef.

Park S, Cho Y, Lee S, Chung H, Jeong K. Triglyceride is a useful surrogate marker for insulin resistance in korean women with polycystic ovary syndrome. Yonsei Med J. 2015; 56(3): 785-92, CrossRef.

Yin J, Li M, Xu L, Wang Y, Cheng H, Zhao X, Mi J. Insulin resistance determined by homeostasis model assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers. Diabetol Metab Syndr. 2013; 5(1): 71, CrossRef.

Qu X, Donnelly R. Sex hormone-binding globulin (SHBG) as an early biomarker and therapeutic target in polycystic ovary syndrome. Int J Mol Sci. 2020; 21(21): 8191, CrossRef.

Liu Y, Du M, Gan Y, Bao S, Feng L, Zhang J. Triglyceride induced metabolic inflammation: potential connection of insulin resistance and recurrent pregnancy loss. Front Endocrinol. 2021; 12: 621845, CrossRef.

Dumesic DA, Padmanabhan V, Chazenbalk GD, Abbott DH. Polycystic ovary syndrome as a plausible evolutionary outcome of metabolic adaptation. Reprod Biol Endocrinol. 2022; 20(1): 12, CrossRef.

Wen J, Wang A, Liu G, Wang M, Zuo Y, Li W, et al. Elevated triglyceride-glucose (TyG) index predicts incidence of prediabetes: a prospective cohort study in China. Lipids Health Dis. 2020; 19(1): 226, CrossRef.

Altemimi M, Musa A, Mansour A. The performance of glycated hemoglobin vs. oral glucose tolerance test in the diagnosis of glycemic disorders among women with polycystic ovary syndrome in Southern Iraq. Indones Biomed J. 2021; 13(2): 178-85, CrossRef.

Yang H, Chen Y, Liu C. Triglyceride-glucose index is associated with metabolic syndrome in women with polycystic ovary syndrome. Gynecol Endocrinol. 2023; 39(1): 2172154, CrossRef.




DOI: https://doi.org/10.18585/inabj.v16i1.2639

Copyright (c) 2024 The Prodia Education and Research Institute

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

Indexed by:

                  

               

                   

 

 

The Prodia Education and Research Institute