EXPLORING THE ASSOCIATION BETWEEN INSULIN RESISTANCE AND METABOLIC, HORMONAL, AND REPRODUCTIVE OUTCOMES IN WOMEN WITH POLYCYSTIC OVARY SYNDROME: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.71000/hkah4w86Keywords:
Polycystic Ovary Syndrome, Insulin Resistance, Hyperandrogenism, Infertility, Metabolic Diseases, Systematic Review.Abstract
Background: Insulin resistance (IR) is a pivotal pathophysiological feature of polycystic ovary syndrome (PCOS), yet its comprehensive impact on the spectrum of metabolic, hormonal, and reproductive outcomes within this population requires systematic elucidation.
Objective: This systematic review aims to evaluate the association between insulin resistance and metabolic, hormonal, and reproductive health outcomes in women diagnosed with PCOS.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for observational studies published between 2014 and 2024. Inclusion criteria encompassed studies comparing PCOS women with and without IR, defined by clamp techniques or validated indices like HOMA-IR. Data extraction and risk of bias assessment, using the Newcastle-Ottawa Scale, were performed by two independent reviewers. A qualitative synthesis of the evidence was conducted.
Results: Eight studies (n=1,843 participants) were included. The presence of IR was consistently associated with a significantly worse metabolic profile, including adverse lipid parameters (elevated triglycerides, lower HDL-C), and a more severe hyperandrogenic phenotype (higher testosterone, lower SHBG). Evidence also suggested IR is linked to poorer reproductive outcomes, including reduced ovulation rates and an increased risk of gestational diabetes.
Conclusion: Insulin resistance identifies a distinct PCOS subgroup with a more severe metabolic and hormonal burden and potentially worse reproductive prognosis. These findings underscore the critical need for routine IR assessment to guide risk stratification and personalized management strategies. Further longitudinal research is warranted to establish causality and explore interventions targeting IR.
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