Insulin resistance in Iraqi women with idiopathic hirsutism in Najaf City: A case–control study

Background: Hirsutism is a common endocrine problem with high prevalence in Iraqi women. Polycystic ovarian syndrome and idiopathic hirsutism (IH) are the most common etiology of this disorder. There is a clear association between insulin resistance and polycystic ovarian syndrome. However, there is insufficient data on the relationship between insulin resistance and IH.

Aim: The aim of this study was to determine whether Iraqi women with IH have insulin resistance.

Methods: The study included two groups: 60 Iraqi women with IH and 60 women without hirsutism as a control group. A physical examination, a medical history, and the patient's age and BMI were collected. Blood samples were collected for hormone analysis, including insulin, follicle-stimulating hormone, luteinizing hormone, prolactin, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and free testosterone. To evaluate insulin resistance in both groups, the homeostasis model assessment-insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were used in addition to the Matsuda index.

Results: Basal insulin was higher in the IH group (9.5 ± 0.2 mIU/L) than in the control group (4.8 ± 3.7 mIU/L), with a p value of < 0.0001. HOMA-IR was higher in the IH group (2.3 ± 4.1 μU mg), while in the control group, it was (0.8 ± 1.2 μU mg), with a p value of 0.007. There was a significant difference in the QUICKI, which was lower in the IH group (0.31 ± 0.2 μU^-1/mg) than in the control group (0.45 ± 0.1 μU^-1/mg), with a p value of < 0.0001. The insulin sensitivity index (Matsuda) was significantly lower in the IH group (3.1 ± 0.4) than in the control group (7.8 ± 1.3), with a p value of < 0.0001.

Conclusion: According to the results of this study, Iraqi women with IH have insulin resistance and higher basal insulin levels.