{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:57:56Z","timestamp":1791352676406,"version":"4.3.1"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,6,28]],"date-time":"2019-06-28T00:00:00Z","timestamp":1561680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the effects of hyperinsulinaemia and insulin resistance (IR) on reproductive and metabolic disorders and fertility in women with polycystic ovary syndrome (PCOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, Participants and Measurements<\/jats:title><jats:p>This was a multicenter, randomized controlled trial involving a total of 1000 women diagnosed with PCOS according to the modified Rotterdam criteria at 21 sites (27 hospitals). We evaluated the effects of serum insulin levels and HOMA\u2010IR on parameters and outcomes. The main outcome measures were anthropometric, biometric and ultrasound parameters at baseline and the clinical outcomes of ovulation, conception, pregnancy, live birth and pregnancy loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The relevant analysis between hyperinsulinaemia and IR and clinical characteristics showed that weight, waist and hip circumference, BMI, waist\u2010to\u2010hip ratio, acanthosis nigricans score and menstrual period were significantly correlated with fasting insulin (FIN) and HOMA\u2010IR. There was no significant correlation between the hirsutism score or acne score with FIN or HOMA\u2010IR. The relevant analysis between hyperinsulinaemia and IR and circulating sex steroids and gonadotrophins showed that FAI was significantly correlated with FIN and HOMA\u2010IR (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.240, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001 and <jats:italic>r<\/jats:italic>\u00a0=\u00a00.191, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, respectively). Free testosterone was significantly correlated with FIN after adjusting for the influence of age. LH and LH\/FSH were not related to FIN or HOMA\u2010IR after statistical correction for differences in BMI. The relevant analysis between hyperinsulinaemia and IR and metabolic profile showed that FIN and HOMA\u2010IR were positively associated with fasting glucose, cholesterol, triglycerides, low\u2010density lipoprotein, Apo B, and the incidence of metabolic syndrome and were negatively associated with high\u2010density lipoprotein. The predictive analysis between hyperinsulinaemia and IR with fertility showed that the levels of FIN and HOMA\u2010IR were related to the fertility outcome (ovulation, pregnancy, conception or live birth) in patients with PCOS. After adjustments for age, total testosterone and free testosterone, increasing serum insulin levels and HOMA\u2010IR were significantly associated with decreased cycle ovulation, conception, pregnancy and live birth rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hyperinsulinaemia and IR are associated with reproductive and metabolic disorders and can predict the fertility outcomes in PCOS patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14050","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T08:03:53Z","timestamp":1561104233000},"page":"440-448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Effect of hyperinsulinaemia and insulin resistance on endocrine, metabolic and fertility outcomes in women with polycystic ovary syndrome undergoing ovulation induction"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7401-4646","authenticated-orcid":false,"given":"Duojia","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2245-6781","authenticated-orcid":false,"given":"Xinming","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1555-4327","authenticated-orcid":false,"given":"Jian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7580-7955","authenticated-orcid":false,"given":"Jiarui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1767-7344","authenticated-orcid":false,"given":"Xiaoke","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.38.9.1165"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.217"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(03)01007-0"},{"key":"e_1_2_10_5_1","unstructured":"BaillargeonJP CarpentierA.Respective role of insulin and LH in the ovarian steroidogenic production of non\u2010obese women with PCOS and normal insulin levels\u2010preliminary results. 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