Predictors of abnormal glucose tolerance among women with polycystic ovary syndrome
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Objective To determine the parameters associated with the risk for abnormal glucose tolerance (AGT) among women with polycystic ovary syndrome (PCOS) and to assess the optimal screening tests to predict AGT within this population. Methods We evaluated 85 women with PCOS and 53 control women. All participants had an oral glucose tolerance test (OGTT) and hormonal blood profiles, including the measurement of follicle stimulating hormone, leutinizing hormone, estradiol testosterone, and serum lipid profiles. Results Among the women with PCOS, those with AGT had significantly higher homeostasis model assessment of insulin resistance (P<0.001) values than those with normal glucose tolerance. The prevalence of impaired glucose tolerance (IGT) and/or impaired fasting glucose was 48.2% (41/85) in women with PCOS; 16 of 41 subjects with AGT were IGT. Six of 16 subjects (37.5%) with IGT had normal fasting plasma glucose (FPG<100 mg/dL). Thus, the FPG failed to detect 37.5% of women with PCOS who were found to have AGT with the OGTT. Multivariate logistic regression analysis revealed that insulin, body mass index (BMI), age, and triglyceride (TG) were significant risk factors for abnormal glucose metabolism. Conclusion Insulin, BMI, age, and TG predicted abnormal glucose metabolism in women with PCOS. The OGTT was a more reliable predictor of AGT than fasting plasma glucose. We recommend that women with PCOS undergo periodic screening for AGT using the OGTT, particularly if they have any of the above risk factors.
Abstract
Objective To determine the parameters associated with the risk for abnormal glucose tolerance (AGT) among women with polycystic ovary syndrome (PCOS) and to assess the optimal screening tests to predict AGT within this population. Methods We evaluated 85 women with PCOS and 53 control women. All participants had an oral glucose tolerance test (OGTT) and hormonal blood profiles, including the measurement of follicle stimulating hormone, leutinizing hormone, estradiol testosterone, and serum lipid profiles. Results Among the women with PCOS, those with AGT had significantly higher homeostasis model assessment of insulin resistance (P<0.001) values than those with normal glucose tolerance. The prevalence of impaired glucose tolerance (IGT) and/or impaired fasting glucose was 48.2% (41/85) in women with PCOS; 16 of 41 subjects with AGT were IGT. Six of 16 subjects (37.5%) with IGT had normal fasting plasma glucose (FPG<100 mg/dL). Thus, the FPG failed to detect 37.5% of women with PCOS who were found to have AGT with the OGTT. Multivariate logistic regression analysis revealed that insulin, body mass index (BMI), age, and triglyceride (TG) were significant risk factors for abnormal glucose metabolism. Conclusion Insulin, BMI, age, and TG predicted abnormal glucose metabolism in women with PCOS. The OGTT was a more reliable predictor of AGT than fasting plasma glucose. We recommend that women with PCOS undergo periodic screening for AGT using the OGTT, particularly if they have any of the above risk factors.
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