Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS?

Abstract

Background: Polycystic ovary syndrome (PCOS) is considered a risk factor f or the development of type 2 diabetes mellitus (T2DM). However, which is the most appropriate way to evaluate dysglycemia in women with PCOS and who are at i ncreased risk are as yet unclear. Aim of the study: To determine the prevalence of T2DM, impaired glucose toleranc e (IGT), and impaired fasting glucose (IFG) in PCOS women and potential factors to identify those at risk. Subjects and methods: The oral glucose tolerance test (OGTT), biochemical/hormonal profile, and ovarian ultrasound data from 1614 Caucasian women w ith PCOS and 362 controls were analyzed in this cross-sectional multicenter study. The data were categorized according to age and BMI. Results: Dysglycemia (T2DM, IGT, and IFG according to World Health Orga nization criteria) was more frequent in the PCOS group compared to controls: 2.2% vs 0.8%, P = 0.04; 9.5% vs 7.4%, P = 0.038; 14.2% vs 9.1%, P = 0.002, respectively. OGTT was essential for T2DM diagnosis, since in 88% of them basal glucose values were incon clusive for diagnosis. The presence of either T2DM or IFG was irrespective of age ( P = 0.54) and BMI (P = 0.32), although the latter was associated with IGT ( P = 0.021). There was no impact of age and BMI status on the prevalence of T2DM or IFG. Regression analysi s revealed a role for age, BMI, fat deposition, androgens, and insulin resistance for dysg lycemia. However, none of the factors prevailed as a useful marker employed in clinical p ractice. Conclusions: One-third of our cohort of PCOS women with either T2DM or IGT displayed normal fasting glucose values but without confirming any specific predictor for dysglycemic condition. Hence, the evaluation of glycemic status using OGTT in all women with PCOS is strongly supported.

Keywords

• polycystic ovary syndrome
• diabetes
• insulin resistance
• androgens
• age
• impaired glucose tolerance