AUTHOR=Biernacka-Bartnik Aleksandra , Kocełak Piotr , Owczarek Aleksander Jerzy , Choręza Piotr Stanisław , Markuszewski Leszek , Madej Paweł , Puzianowska-Kuźnicka Monika , Chudek Jerzy , Olszanecka-Glinianowicz Magdalena 

TITLE=The cut-off value for HOMA-IR discriminating the insulin resistance based on the SHBG level in women with polycystic ovary syndrome

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1100547

DOI=10.3389/fmed.2023.1100547

ISSN=2296-858X

ABSTRACT=Introduction: The study aimed to estimate the cut-off value for homeostatic model assessment for insulin resistance (HOMA-IR) discriminating the insulin resistance based on the sex hormones binding globulin (SHBG) level in women with polycystic ovary syndrome (PCOS).
Material and Methods: Data from medical records of 854 Caucasian women diagnosed with PCOS were analyzed. Anthropometric data, fasting plasma glucose, insulin and SHBG levels were measured. HOMA-IR was calculated with a standard formula. The cut-off value was calculated using receiver-operating characteristics.   
Results: Circulating SHBG levels below the normal range (26.1 nmol/L) were found in 25.4% of study participants. This subgroup had a significantly higher BMI, fasting glucose and insulin concentrations and HOMA-IR values. Empirical optimal cut-off values for HOMA-IR corresponding to low SHBG levels was ≥ 2.1 (area under the curve [AUC] 0.73, accuracy 0.65, sensitivity 72.3%, specificity 63.1%, positive predictive value [PPV] 40.0%, negative predictive value [NPV] 87.0%). 
Conclusion: Our study suggests that the cut-off point for HOMA-IR discriminating the insulin resistance based on the SHBG level, in young Caucasian women with polycystic ovary syndrome is 2.1, and is consistent with the cut-off value adopted by the European Group for the Study of Insulin Resistance (above 2.0).