Insulin resistance and idiopathic hirsutism: A systematic review, meta-analysis, and meta-regression.
idiopathic hirsutism (IH)
insulin resistance
polycystic ovary syndrome (PCOS)
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
revised:
17
04
2022
received:
17
03
2022
accepted:
05
05
2022
pubmed:
10
5
2022
medline:
28
12
2022
entrez:
9
5
2022
Statut:
ppublish
Résumé
This study aimed to evaluate the Standardized Mean Difference (SMD) of insulin resistance parameters in women with IH, compared to healthy and polycystic ovary syndrome (PCOS) controls. PubMed, Scopus, Web of Sciences, and Embase were searched for retrieving studies published up to November 2021 investigating the insulin resistance parameters in women with IH, compared to control groups. Meta-regression and subgroup analysis were conducted to evaluate the effect of potential confounders, such as age, BMI, and study design. A meta-analysis of 20 studies revealed that higher SMDs of fasting insulin (SMD: 0.58; 95% CI: 0.10, 1.06), HOMA-IR (SMD: 0.53; 95% CI: 0.09, 0.97), and FBS levels (SMD: 0.11; 95% CI: 0.03, 0.19) in women with IH than healthy. It also showed that the SMD of HOMA-IR was significantly lower in women with IH than PCOS patients (SMD: -0.49; 95% CI: -0.88, -0.09). A subgroup analysis of cross-sectional studies showed higher SMDs of fasting insulin (SMD: 0.86; 95% CI: 0.05, 1.68), HOMA-IR (SMD: 0.83; 95% CI: 0.01, 1.64), and FBS levels (SMD: 0.14; 95% CI: 0.00, 0.28) in women with IH than healthy, whereas there was no difference in the SMD of these metabolic parameters between IH and PCOS groups, except for SMD of HOMA-IR (SMD: -0.22; 95% CI: -0.42, -0.02). The results of the study demonstrate that insulin resistance parameters are related to IH, although insulin resistance values in women with IH are not as high as in patients with PCOS. According to the results of the study, measuring these metabolic parameters can be beneficial to evaluate all hirsute women with IH.
Substances chimiques
Insulin
0
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
5346-5359Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev. 2000;21(4):347-362.
Azziz R, Carmina E, Dewailly D, et al. The androgen excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91(2):456-488.
Bakry OA, Al Gayed EM, Seadan AG. Assessment of obesity, dyslipidemia, and insulin resistance in idiopathic hirsutism: a case-control study. J Egypt Women's Dermatol Soc. 2020;17(2):113.
Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Endocrine evaluation of hirsutism. Int J Women's Dermatol. 2017;3(1):S6-S10.
Ansarin H, Azizi JM, Rasi A, Soltani AR. Clinical presentation and etiologic factors of hirsutism in premenopausal Iranian women. 2007.
Azziz R, Waggoner WT, Ochoa T, Knochenhauer ES, Boots LR. Idiopathic hirsutism: an uncommon cause of hirsutism in Alabama. Fertil Steril. 1998;70(2):274-278.
Jiang M, Aittomäki K, Nilsson C, et al. The frequency of an inactivating point mutation (566C→T) of the human follicle-stimulating hormone receptor gene in four populations using allele-specific hybridization and time-resolved fluorometry. J Clin Endocrinol Metabol. 1998;83(12):4338-4343.
Barth J, Catalan J, Cherry C, Day A. Psychological morbidity in women referred for treatment of hirsutism. J Psychosom Res. 1993;37(6):615-619.
Sonino N, Fava G, Mani E, Belluardo P, Boscaro M. Quality of life of hirsute women. Postgrad Med J. 1993;69(809):186-189.
Arduc A, Sarıcam O, Dogan BA, et al. Should insulin resistance be screened in lean hirsute women? Gynecol Endocrinol. 2015;31(4):291-295.
Cakir E, Topaloğlu O, Bozkurt NÇ, et al. Insulin-like growth factor 1, liver enzymes, and insulin resistance in patients with PCOS and hirsutism. Turk J Med Sci. 2014;44(5):781-786.
Kopera D, Wehr E, Obermayer-Pietsch B. Endocrinology of hirsutism. Int J Trichol. 2010;2(1):30-35.
Dasgupta A, Khan A, Banerjee U, et al. Predictors of insulin resistance and metabolic complications in polycystic ovarian syndrome in an eastern Indian population. Indian J Clin Biochem. 2013;28(2):169-176.
Ucak S, Basat O, Satir E, Altuntas Y. Evaluation of various insulin sensitivity indices in lean idiopathic hirsutism patients. Endocr J. 2012;59:291-296.
Paoletti AM, Cagnacci A, Orrù M, Ajossa S, Guerriero S, Melis GB. Treatment with flutamide improves hyperinsulinemia in women with idiopathic hirsutism. Fertil Steril. 1999;72(3):448-453.
Rosenfield RL. Polycystic ovary syndrome and insulin-resistant hyperinsulinemia. J Am Acad Dermatol. 2001;45(3):S95-S104.
Escobar-Morreale HF, Jn S-G, Garcı́a-Robles R, Varela C, Sancho JM. Abnormalities in the serum insulin-like growth factor-1 axis in women with hyperandrogenism. Fertil Steril. 1998;70(6):1090-1100.
Dunaif A, Sorbara L, Delson R, Green G. Ethnicity and polycystic ovary syndrome are associated with independent and additive decreases in insulin action in Caribbean-Hispanic women. Diabetes. 1993;42(10):1462-1468.
Shoupe D, Kumar DD, Lobo RA. Insulin resistance in polycystic ovary syndrome. Am J Obstet Gynecol. 1983;147(5):588-592.
Talaei A, Adgi Z, Mohamadi Kelishadi M. Idiopathic hirsutism and insulin resistance. Int J Endocrinol. 2013;2013:1-5.
Budeč M, Pjević M. The insulin response to oral glucose, concentrations of total cholesterol, triglycerides and uric acid in women with idiopathic hirsutism. Exp Clin Endocrinol Diabetes. 1989;94(06):300-304.
Sadat Hosseini M, Ramezani Tehrani F, Azizi F. The lack of association between idiopathic hirsutism and metabolic disturbances: Iranian PCOS prevalence study. Gynecol Endocrinol. 2013;29(9):821-825.
Bonakdaran S, Kiafar B, Barazandeh Ahmadabadi F. Evaluation of insulin resistance in idiopathic hirsutism compared with polycystic ovary syndrome patients and healthy individuals. Australas J Dermatol. 2016;57(1):e1-e4.
Sarac F, Saygili F, Özgen G, Tuzun M, Yılmaz C, Kabalak T. Assessment of insulin resistance in the idiopathic hirsutism. Gynecol Obstet Invest. 2007;63(3):126-131.
Tehrani FR, Behboudi-Gandevani S, Simbar M, Azizi F. A population-based study of the relationship between idiopathic hirsutism and metabolic disturbances. J Endocrinol Invest. 2015;38(2):155-162.
ÜnlÜhizarci K, Karababa Y, Bayram F, Kelestimur F. The investigation of insulin resistance in patients with idiopathic hirsutism. J Clin Endocrinol Metabol. 2004;89(6):2741-2744.
Erkan M, Albayrak M, Karatas A, et al. Are insulin resistance and serum resistin levels increased in women with idiopathic hirsutism. Eur Rev Med Pharmacol Sci. 2014;18(13):1889-1895.
Cebeci F, Onsun N, Mert M. Insulin resistance in women with hirsutism. Arch Med Sci. 2012;8(2):342-346.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:1-9.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-605. doi:10.1007/s10654-010-9491-z
Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54(10):1046-1055.
Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455-463.
Balduzzi S, Rücker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health. 2019;22(4):153-160.
Toscani M, Migliavacca R, de Castro JAS, Spritzer PM. Estimation of truncal adiposity using waist circumference or the sum of trunk skinfolds: a pilot study for insulin resistance screening in hirsute patients with or without polycystic ovary syndrome. Metabolism. 2007;56(7):992-997.
Al-Ruhaily AD, Malabu UH, Sulimani RA. Hirsutism in Saudi females of reproductive age: a hospital-based study. Ann Saudi Med. 2008;28(1):28-32.
Tehrani FR, Rashidi H, Azizi F. The prevalence of idiopathic hirsutism and polycystic ovary syndrome in the Tehran Lipid and Glucose Study. Reprod Biol Endocrinol. 2011;9(1):144.
Cakir E, Doğan M, Topaloglu O, et al. Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis. 2013;226(1):291-295.
Tehrani FR, Rashidi H, Khomami MB, Tohidi M, Azizi F. The prevalence of metabolic disorders in various phenotypes of polycystic ovary syndrome: a community based study in Southwest of Iran. Reprod Biol Endocrinol. 2014;12(1):89.
Glintborg D, Henriksen JE, Andersen M, et al. Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril. 2004;82(6):1570-1579.
Azziz R, Sanchez L, Knochenhauer E, et al. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metabol. 2004;89(2):453-462.
Fattah NSA, Darwish Y. Is there a role for insulin resistance in nonobese patients with idiopathic hirsutism? Br J Dermatol. 2009;160(5):1011-1015.
Wiltgen D, Spritzer PM. Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes. Fertil Steril. 2010;94(6):2493-2496.
Anaforoglu I, Algun E, Incecayir O, Ersoy K. Higher metabolic risk with National Institutes of Health versus Rotterdam diagnostic criteria for polycystic ovarian syndrome in Turkish women. Metab Syndr Relat Disord. 2011;9(5):375-380.
Pugeat M, Forest MG, Nisula BC, Corniau J, De EP, Tourniaire J. Evidence of excessive androgen secretion by both the ovary and the adrenal in patients with idiopathic hirsutism. Obstet Gynecol. 1982;59(1):46-51.
Ehrmann DA, Rosenfield RL, Barnes RB, Brigell DF, Sheikh Z. Detection of functional ovarian hyperandrogenism in women with androgen excess. N Engl J Med. 1992;327(3):157-162.
Morán C, Tapia MC, Hernández E, Vázquez G, García-Hernández E, Bermúdez JA. Etiological review of hirsutism in 250 patients. Arch Med Res. 1994;25(3):311-314.
Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141(3):333-338.
Škrha J, Ts H, Šindelka G, et al. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis model assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metabol. 2004;89(1):135-141.
Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005;115(4):e500-e503.
Lawson MA, Jain S, Sun S, Patel K, Malcolm PJ, Chang RJ. Evidence for insulin suppression of baseline luteinizing hormone in women with polycystic ovarian syndrome and normal women. J Clin Endocrinol Metabol. 2008;93(6):2089-2096.