HOMA-IR

This study investigates the relationship between plasma homocysteine levels and insulin resistance in patients with polycystic ovary syndrome (PCOS). A cohort of 155 infertile PCOS patients was screened for insulin resistance using fasting insulin, glucose-to-insulin ratio, and the homeostasis model assessment (HOMA) index, while 100 normo-ovulatory women with normal ovaries served as controls. Results revealed a significantly higher mean plasma homocysteine level in the PCOS group compared to controls (11.5 ± 7.4 vs. 7.4 ± 2.1 μmol/L, P < 0.001). Insulin-resistant PCOS patients exhibited even higher homocysteine levels than their non-insulin-resistant counterparts (P = 0.003), independent of body mass index. Furthermore, 34% of PCOS patients had homocysteine levels above the 95th percentile of controls. Significant correlations were found between insulin resistance indices and homocysteine levels, with multiple logistic regression identifying insulin resistance as the primary determinant of elevated homocysteine. These findings suggest that hyperinsulinemia in PCOS contributes to increased homocysteine levels, which may have implications for both reproductive outcomes and long-term cardiovascular risk.