Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome

Hurd, William W.; Abdel-Rahman, Mohamed; Ismail, Salah A.; Abdellah, Mostafa A.; Schmotzer, Christine; Sood, Anil K.

doi:10.1016/j.fertnstert.2011.07.002

Cited by 41 publications

(20 citation statements)

References 30 publications

(49 reference statements)

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“…Screening for T2D and insulin resistance " Fasting plasma glucose and HbA1c are not sensitive methods of screening for T2D in situations of risk, such as PCOS (77,78), although as a screening tool with adjusted criteria, fasting glucose may have some utility (79). According to the AE-PCOS Society, an oral glucose tolerance test should be performed in all obese women, as well as in lean PCOS women with advanced age (O40 years), in the presence of a personal history of gestational diabetes or family history of T2D (80,81).…”

Section: Laboratory and Biomarkersmentioning

confidence: 99%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

576

492

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Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject. This paper offers a critical endocrine and European perspective on the debate on the definition of PCOS and summarises all major aspects related to aetiological factors, including early life events, potentially involved in the development of the disorder. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. We have also paid specific attention to the role of obesity, sleep disorders and neuropsychological aspects of PCOS and on the relevant pathogenetic aspects of cardiovascular risk factors. In addition, we have discussed how to target treatment choices based according to the phenotype and individual patient's needs. Finally, we have suggested potential areas of translational and clinical research for the future with specific emphasis on hormonal and metabolic aspects of PCOS.

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Section: Laboratory and Biomarkersmentioning

confidence: 99%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

576

492

View full text Add to dashboard Cite

show abstract

“…In a study by Stovall et al (17) found insulin resistance and impaired glucose tolerance was far less common in lean young PCOS women than obese women and also BMI was highly predictive of insulin and glucose levels. Hurd et al (18) in their study found that obesity was an accurate marker of IR in PCOS women. A Japanese study (19) found insulin resistance among lean PCOS using HOMA method.…”

Section: Discussionmentioning

confidence: 93%

Insulin Resistance and Secretory Capacity in Young Women With Polycystic Ovary Syndrome

Neelaveni¹,

Sahay²

2016

jemds

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BACKGROUNDInsulin resistance is an intrinsic component in the complex pathophysiology of PCOS, causing reproductive and metabolic abnormalities. Studies on insulin secretion in PCOS are sparse and contrast.Objective is to assess insulin resistance and insulin secretory capacity by Homeostasis Model Assessment in young women with polycystic ovary syndrome. MATERIALS AND METHODSFifty young women with PCOS (mean age 21 years) and fifty control women matched as a group for age and BMI were studied. A complete hormonal assay, other laboratory parameters of glycaemic status, cholesterol status were studied in each subject. Homeostasis Model Assessment, computerised calculator used for assessing insulin resistance and secretion. RESULTSThe mean age of PCOS women and control women was 21.18±1.8 years, 20.9±1.74 years (P value -0.432). The mean waist circumference was non-significantly higher in PCOS women than in controls (90.44±4.15 vs 89.0±5.42, p = 0.141), whereas Waist Hip Ratio (WHR) was significantly different among PCOS and control women (0.83±0.008 vs 0.823±0.011, p = 0.002). TSH, prolactin and 17-hydroxyprogesterone were not significantly different between the groups, whereas testosterone and LH/FSH ratio was significantly different. Fasting glucose concentrations were within normal range, but significantly higher in PCOS women than control women (90.9±3.26 mg/dL vs 87.24±2.43 mg/dL, p = 0.001). The fasting insulin concentrations were higher in PCOS women than controls. HOMA-IR, HOMA-β% were significantly higher in PCOS women than control women, whereas HOMA-S% was significantly lower. PCOS women were more insulin resistant and had increased insulin secretion than controls even after adjusting for BMI. Impaired glucose tolerance was found in 12% (n=6) PCOS women. The mean serum levels of total cholesterol, LDL and triglycerides were significantly higher in PCOS women than controls, whereas HDL cholesterol were significantly lower in PCOS women and controls). HOMA-IR and HOMA-β% correlated positively well with BMI, testosterone. CONCLUSION HOMA-IR was higher among normal, overweight and obese PCOS women. Insulin secretion was higher among PCOS women to maintain euglycaemia. Higher prevalence of impaired glucose tolerance was found in PCOS women.

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“…In view of our finding, we suggest that even young and non-obese subjects with PCOS need to be screened for type 2 diabetes to ensure early intervention. Comparison of diagnostic methods for identifying pre-diabetes and diabetes in PCOS subjects by Hurd et al [14] showed that HbA 1C was effective in identifying 20% subjects with normal OGTT as having prediabetes and concluded that PCOS patients should be screened for glycemic status using HbA 1C or OGTT.…”

Section: Discussionmentioning

confidence: 99%

Study of Glycated Hemoglobin Levels in Polycystic Ovary Syndrome

Pangaluri

Shakthiya

Vinodhini

2018

Asian J Pharm Clin Res

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Objective: Polycystic ovarian syndrome (PCOS) is often accompanied by insulin resistance, obesity, and cardiometabolic risk factors. Androgen excess-PCOS recommends oral glucose tolerance test or glycated hemoglobin (HbA 1C ) to evaluate dysglycemia in PCOS subjects. We undertook this study to evaluate the prevalence of elevated HbA 1C levels in PCOS women. Methods:The study was carried out among 100 PCOS patients from SRM Hospital, 100 healthy individuals were included as controls. Fasting glucose, HbA 1C , Insulin and Homeostasis Model Assessment-Insulin Resistance Index were estimated. Results:Patients with polycystic ovary syndrome showed a significant increase in HbA 1C levels (5.799±1.022; 4.96±0.625, p=0.001) when compared to the control group. Conclusion:We found elevated HbA 1C levels in PCOS women categorizing 26% as prediabetes and 28% as having type 2 diabetes mellitus.

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Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome

Cited by 41 publications

References 30 publications

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Insulin Resistance and Secretory Capacity in Young Women With Polycystic Ovary Syndrome

Study of Glycated Hemoglobin Levels in Polycystic Ovary Syndrome

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