Wrist circumference: A new marker for insulin resistance in African women with polycystic ovary syndrome

Chantal Anifa Amisi; Massimo Ciccozzi; Paolo Pozzilli

doi:10.4239/wjd.v11.i2.42

Wrist circumference: A new marker for insulin resistance in African women with polycystic ovary syndrome

World J Diabetes. 2020 Feb 15;11(2):42-51. doi: 10.4239/wjd.v11.i2.42.

Authors

Chantal Anifa Amisi¹, Massimo Ciccozzi², Paolo Pozzilli³

Affiliations

¹ Endocrinology and Diabetes Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy. chantalamisi@yahoo.fr.
² Medical Statistics and Epidemiology Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy.
³ Endocrinology and Diabetes Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy.

Abstract

Background: Insulin resistance (IR) is the main complication found in 35%-80% of women with polycystic ovary syndrome (PCOS). However, there is no definite consensus regarding which marker to use for its assessment in PCOS women. Research has shown that hyperinsulinemia is correlated with increased bone mass. Given that most women with PCOS are insulin resistant, which is independent from body fat and characterized by hyperinsulinemia, it could be hypothesized that there would be an increased bone mass in the patient as a result. Subsequently, increased bone mass could be measured using the wrist circumference method.

Aim: To assess the wrist circumference as an easy-to-detect marker of IR in Congolese women with PCOS.

Methods: Seventy-two Congolese women with PCOS and seventy-one controls from the same ethnic group, were enrolled in the study (mean age 24.33 ± 5.36 years). Fasting biochemical parameters, and the Homeostasis Model Assessment of insulin resistance (HOMA-IR) and body composition were evaluated. The non-dominant wrist circumference was measured manually, as was the waist circumference (WC), hip circumference, height and weight. Calculated measures included evaluation of body mass index (BMI), Waist-to-Height (WHtR) and Waist-to-hip ratio (WHR). In addition, body composition was assessed by Bioelectrical Impedance Analysis using a body fat analyzer.

Results: The non-dominant wrist circumference was more closely correlated with HOMA-IR (r = 0.346; P = 0.003) and was the best anthropometrical marker correlated with IR (P = 0.011 ) compared with other anthropometrical markers in women with PCOS: Dominant Wrist Circumference (r = 0.315; P = 0.007), Waist Circumference (WC) (r = 0.259; P = 0.028), BMI (r = 0.285; P = 0.016), WHR (r = 0.216; P = 0,068) and WHtR (r = 0.263; P = 0.027). The diagnostic accuracy of the non-dominant wrist circumference for the presence or absence of IR using Receiver-operating characteristic (ROC) curve analysis showed that the area under the ROC curve was 0.72. A cutoff value for the non-dominant wrist circumference of 16.3 cm was found to be the best predictor of IR in Congolese women with PCOS.

Conclusion: Non-dominant wrist circumference is, to date, the best anthropometrical marker of IR in Sub-Saharan African women with PCOS. It could be suggested as an easy-to-detect marker for assessing IR.

Keywords: Congolese women; Easy-to-detect marker; Homeostasis Model Assessment of insulin resistance; Insulin resistance; Marker of insulin resistance; Polycystic ovary syndrome; Sub-Saharan African women; Wrist circumference.