The Value of Different Obese Criteria for the Assessment of Insulin Resistance in Women with Polycystic

Objective To investigate the value of three different obese criteria: body mass index (BMI), waist circumference (WC) and visceral fat area (VAA, CT measurement) in the evaluation of polycystic overy syndrome (PCOS) with insulin resistance. Methods There were 300 cases of PCOS included in this study. According to the three criteria, there were 210 cases of abdominal obesity (WC≥80 cm), and 90 cases of non-abdominal obesity (WC<80 cm); 97 cases of overall obesity (BMI≥25 kg/m²), and 203 cases of non-overall obese (BMI<25 kg/m²); 198 cases of visceral obesity (VAA≥80 cm²), and 102 cases non-visceral obesity (VAA<80 cm²). Fasting plasma glucose (FPG) and fasting insulin (FINS) were detected, and HOMA-IR index was calculated; analyze the detection rate of the three criteria in the diagnosis of obese PCOS patients and insulin resistance. The serum levels of sex hormones, thyroid hormones, and plasma total cortisol (PTC) were measured as well. Results ①The levels of blood hormone (including LH/FSH), thyroid hormone, PTC, fasting blood glucose were no significant differences between groups (P>0.05), while the weight and fasting insulin were significantly difference between groups (P<0.05) in three different obese. ②The detection rates of obese PCOS patients in three criteria: overall obesity was 32.33% (97/300), abdominal obesity was 70.00% (210/300), visceral obesity was 66.00% (198/300). Compared to WC and VAA, BMI had the lowest detection rate of obesity, the differences were statistically significant (P<0.05), while the detection rates of obesity in VAA and WC were no significant difference (P>0.05). ③The detection rates of insulin resistance in BMI,WC,VAA were respectively 38.60% (83/215), 85.11% (183/215), 69.77% (150/215), the differences were significant (P<0.05).④The misdiagnosis rates of insulin resistance in BMI, WC,VAA were 6140% (132/215), 14.88% (32/215), 30.23% (65/215) respectively, and the differences were statistically significant (P<0.05). Conclusion There was obviously insufficient of BMI in screening obesity, WC may has more advantages than BMI and VAA in the assessment of insulin resistance in obese PCOS patients.