Predictive Value of Ovarian Stromal Doppler Ultrasonography for Insulin Resistance in Polycystic Ovary Syndrome

Open Access

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder frequently associated with insulin resistance, which contributes to both reproductive and metabolic complications. Identification of a reliable, noninvasive marker for insulin resistance may facilitate early risk assessment and management. Aim of the study: To evaluate the predictive value of ovarian stromal Doppler ultrasonography for insulin resistance in women with PCOS and to determine its correlation with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Methods & Materials: This cross-sectional analytical study was conducted among 65 women aged 18-35 years diagnosed with PCOS according to the Rotterdam criteria. Clinical, anthropometric, biochemical, and hormonal data were collected. Insulin resistance was assessed using HOMA-IR, and participants were categorized into insulin-resistant (HOMA-IR ≥2.5) and non-insulin-resistant (HOMA-IR <2.5) groups. Ovarian stromal Doppler parameters including Resistance Index (RI), Pulsatility Index (PI), Peak Systolic Velocity (PSV), ovarian volume, and stromal area were measured. Correlation, regression n, and receiver operating characteristic (ROC) curve analyses were performed. Results: The mean age of participants was 25.8 ± 4.3 years and the mean HOMA-IR was 4.21 ± 2.04. Insulin-resistant women demonstrated significantly lower RI and PI and significantly higher PSV, ovarian volume, and stromal area compared with non-insulin-resistant women (p<0.05). HOMA-IR showed significant negative correlations with RI (r=-0.52) and PI (r=-0.46), while positive correlations were observed with PSV (r=0.59), ovarian volume (r=0.41), and stromal area (r=0.55). Multiple linear regression identified PSV (β=0.38, p<0.001), BMI (β=0.32, p=0.002), RI (β=-0.29, p=0.006), and ovarian volume (β=0.21, p=0.019) as independent predictors of HOMA-IR. ROC analysis demonstrated that PSV had the highest diagnostic accuracy for predicting insulin resistance (AUC=0.84, sensitivity=81.0%, specificity=73.9%). Conclusion: Ovarian stromal Doppler ultrasonography is a useful noninvasive tool for predicting insulin resistance in women with PCOS. Among Doppler parameters, PSV exhibited the strongest predictive performance and may serve as a valuable non-invasive surrogate marker for early metabolic risk stratification.