Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Abnormal Uterine Bleeding (AUB) is a popular gynecological disease whose etiology is multifactorial, which includes metabolic dysregulation. The main study aim was to test the correlation between AUB subtypes and IR, with the hypothesis that IR is higher and more severe in AUB patients, especially those with heavy menstrual bleeding or comorbid with PCOS. The second set of objectives included the investigation of metabolic indicators (glucose, insulin) and the identification of independent predictors of AUB in a multivariate model. Method: This study was a cross-sectional analysis of 135 patients. We summarized all clinical outcomes of AUB subtypes and the prevalence of IR (HOMA-IR ≥ 2.5). The chi-square and ANOVA statistics were used to test the association between IR severity and AUB subtype. T-tests were used to compare metabolic markers, and multivariate logistic regression was done to correct for the effect of age and smoking. PCOS and non-PCOS patients were analyzed using a subgroup to compare the characteristics of the patients regarding their symptoms. Findings: IR was common among 54.1% of the participants, and much higher between AUB subgroups (heavy bleeding). AUB was also independently related to IR (adjusted OR=2.1, p=0.01). PCOS exacerbated IR risk (73.8% vs. 45.2%, p<0.001). AUB patients had a greater level of metabolic derangements (elevated glucose, insulin) (p<0.05). Multivariate analysis proved that IR is a predictor of AUB, as well as age and PCOS. Symptoms that were reported by patients (e.g., fatigue) were related to IR status. Conclusion: The research highlights the presence of a strong correlation between AUB and IR, regardless of the presence of PCOS, with metabolic dysregulation being a possible mechanism to support this association. The prevalence of IR is high in AUB subgroups, especially heavy bleeding, which indicates the need to screen the patients to avoid metabolic dysfunction.