Comparison of various simple insulin sensitivity and β-cell function indices in lean hyperandrogenemic and normoandrogenemic young hirsute women

Objective: To assess and compare various simple insulin sensitivity and beta-cell function indices in lean, hirsute, young women. Design: Prospective study. Setting: Departments of endocrinology and metabolism at a university and a state hospital. Patient(s): Seventy-one hirsute young women were classified as hyperandrogenemic or normoandrogenemic. Main Outcome Measure(s): Insulin sensitivity and beta-cell function indices derived from a single sample and an oral glucose tolerance test (OGTT). Result(s): Lean hyperandrogenemic hirsute women have insulin resistance and increased beta-cell function. The most sensitive indices of insulin resistance were total and 1-hour and 2-hour post-challenge insulin levels during OGTT. When a cut-off value of 3.2 or greater for homeostasis model assessment of insulin resistance (HOMA-IR) was accepted, 46% of hyperandrogenemic women and 30% of normoandrogenemic women were insulin resistant. Fasting insulin level was best correlated with the fasting insulin resistance index, HOMA-IR, and Quicky index. The HOMA-IR was best correlated with fasting insulin level and the hepatic insulin sensitivity index (ISIHOMA). Conclusion(s): Insulin levels based on OGTT are the most useful index of insulin resistance and beta-cell function index in hirsute women. The HOMA-IR may be a proposed global test for insulin resistance; it correlated well with both OGTT-derived insulin resistance and beta-cell function indices and with global insulin resistance indices derived from a single sample (such as ISIHOMA, Quicky index, FIRI-1, fasting Belfiore index, and glucose/insulin ratio). (C)2003 by American Society for Reproductive Medicine.