Area under the curve of carotid artery Doppler as a sensitive marker of insulin sensitivity among Iraqi women with polycystic ovarian syndrome: a cross-sectional study

ABSTRACT

Objective. Polycystic ovarian syndrome (PCOS), a common endocrinopathy of reproductive-aged women, harbours increased insulin resistance (IR) and cardiovascular risk. Screening for associated health risks reduces morbidity and mortality. Measurement of intima-media thickness (IMT) by carotid artery Doppler (CCA) was tested as a marker for IR previously; herein, we aimed to verify the value of area under the curve (AUC) of CCA Doppler wave as a possible marker for IR in PCOS.
Patients and Methods. 140 PCOS women were recruited from the ultrasound department of Al-Yarmouk Hospital; from CCA-Doppler, we recorded CCA-IMT, pulsatility index (PI), and resistance index (RI). By Graph software, AUC-CCA was calculated for all. Patients’ biochemical (lipid and glucose) and hormonal parameters (FSH, LH, insulin, and testosterone) were checked. Lastly, PCOS cases were split into three subgroups based on IR centile to show the relationship between CCA and AUC.
Results. There are strong inverse correlations between CCA-AUC versus HDL and SHBG (-0.98, -0.99), p < 0.0001. CCA-AUC correlated strongly and positively with [LDL, Cholesterol, LH/FSH, Serum Insulin, CCA-IMT, and HOMA-IR], r = (0.99, 0.78, 0.98, 0.97, 0.99, 0.99), p < 0.0001. Sub-group analysis signified increased CCA- AUC with increasing IR severity (31.83 ± 3.90, 46.54 ± 5.03, 59.96 ± 2.57), p < 0.001; likewise, RI and PI of the CCA showed positive correlations (p = 0.040, p = 0.758) respectively.
Conclusions. A strong correlation of CCA-AUC with all hormonals, biochemical, and biophysical changes among PCOS cases, in addition to its simplicity and accuracy, makes CCA-AUC a recommendable parameter in PCOS women for diagnostic and prognostic values.