Oral glucose tolerance test significantly impacts the prevalence of abnormal glucose tolerance among Indian women with polycystic ovary syndrome: lessons from a large database of two tertiary care centers on the Indian subcontinent

Ganie, Mohd Ashraf; Dhingra, Atul; Nisar, Shazia; Sreenivas, Vishnubhatla; Shah, Zafar A.; Rashid, Aafia; Masoodi, Shariq Rashid; Gupta, Nidhi

doi:10.1016/j.fertnstert.2015.09.005

Cited by 27 publications

(18 citation statements)

References 54 publications

(107 reference statements)

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“…Similarly, in this phenotype the level of total testosterone is significantly higher. The obtained results are consistent with many other studies carried out in this area [17][18][19][20][21], but they are in contrast to the results obtained by Ganie et al [22]. The reason for the differences may be the use of only one of the androgenisation exponents (e.g.…”

Section: Discussionsupporting

confidence: 90%

The value of the free androgen index depends on the phenotype of polycystic ovary syndrome — a single-centre experience

Ożga

Krzyczkowska-Sendrakowska

Hubalewska‐Dydejczyk

et al. 2019

Endokrynologia Polska

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Introduction: The free androgen index (FAI) values differ among patients with polycystic ovarian syndrome; however, the differences are not fully understood or known. The aim of the study was to evaluate FAI in women with polycystic ovary syndrome (PCOS) in regard to the phenotype of the PCOS and insulin resistance status. Material and methods: Anthropometric, hormonal, and biochemical parameters were assessed in 312 recruited women with PCOS. The FAI values were calculated in the reproductive and metabolic phenotypes of PCOS in groups of insulin resistance status based on the homeostasis model assessment-insulin resistance (HOMA-IR) > 2.0 or fasting insulin (FI) > 10 mmol/L. To test the relationship between individual variables, Spearman's correlation analysis, the Kolmogorov-Smirnov test, and Student's t-test were used. Results: The correlation between FAI values and HOMA-IR and FI was 0.42 and 0.47, respectively, in PCOS patients. A two fold higher FAI value was observed in metabolic PCOS phenotype when compared to the reproductive one (8.51 ± 5.56 vs. 4.40 ± 2.45 for HOMA-IR and 8.73 ± 6.09 vs. 4.31 ± 3.39 for FI, respectively; p < 0.05). Conclusions: PCOS patients are not a homogenous group in terms of FAI value. Patients with metabolic PCOS phenotype are characterised by twofold higher FAI values compared with reproductive PCOS phenotype. Further studies on the metabolic and androgenic status of different types of PCOS phenotypes should be carried out.

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Section: Discussionsupporting

confidence: 90%

The value of the free androgen index depends on the phenotype of polycystic ovary syndrome — a single-centre experience

Ożga

Krzyczkowska-Sendrakowska

Hubalewska‐Dydejczyk

et al. 2019

Endokrynologia Polska

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“…Previous studies reported that PCOS women with IGT or T2DM had higher testosterone levels compared to those with NGT [ 4 , 7 , 10 ], in accordance with our findings. However, there is a controversy as others found no differences [ 11 ]. The probable reason is that most studies selected just one kind of androgens (such as total testosterone/androstenedione) as the indicator of androgen excess, which may lead to some omissions as PCOS women always show different features of biochemical hyperandrogenism [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, according to certain studies, testosterone evaluation alone may potentially lead to omissions related to androgen excess [ 9 ]. Also, there is a controversy between existing studies on relationships between testosterone and glucose intolerance, since some reported higher testosterone levels in PCOS women with either impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM) compared to those with NGT [ 10 ], while others found no differences [ 11 ]. Sex hormone-binding globulin (SHBG) has been reported as a protein which could bind to testosterone and regulate its clinical action [ 12 ], and there is increasing evidence showing that lower circulating levels of SHBG contribute to T2DM and metabolic syndrome in the general population [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Androgen Excess with Glucose Intolerance in Women with Polycystic Ovary Syndrome

Zhang

Wang

Shen

et al. 2018

BioMed Research International

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Women with polycystic ovary syndrome (PCOS) show high prevalence of glucose intolerance. This study aimed to investigate the association of androgen excess with glucose intolerance in PCOS. A total of 378 women with PCOS participated in the study. Free androgen index (FAI) was selected as indicator of hyperandrogenism. Insulin sensitivity was assessed by 1/homeostasis model assessment of insulin resistance (1/HOMA-IR) and Matsuda insulin sensitivity index (ISIM); β-cell function was assessed by disposition index (DI). We found that women with glucose intolerance had higher FAI levels compared to women with normal glucose tolerance (NGT) (prediabetes 6.2, T2DM 7.9 versus NGT 5.0, resp.; p < 0.001). Furthermore, there was a direct association between FAI levels and frequency of glucose intolerance (OR = 2.480, 95% CI 1.387–4.434), even after adjusting for age, BMI, waist circumference, hypertension, fasting insulin, testosterone, SHBG, and family history of diabetes. In addition, with FAI increase, glycosylated hemoglobin (HbA1c), plasma glucose concentrations, and serum insulin levels increased, while insulin sensitivity and β-cell function decreased. Our results suggested that androgen excess indicated by high FAI levels might serve as indicator of glucose intolerance, as it might promote insulin resistance and β-cell dysfunction in women with PCOS.

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“…A higher prevalence of NAFLD was observed in women with PCOS compared to controls in the present study. Many case-control studies from Brazil, China, Korea and also from India (in a small subset of patients) have demonstrated increased prevalence of NAFLD in young women with PCOS suggesting a link between PCOS and NAFLD 8 12 18 19 20 21 22 23 . Furthermore, NAFLD in these studies was independent of overweight/obesity and other coexisting MS features with more likelihood of having severe forms of NAFLD (non-alcoholic steatohepatitis, advanced fibrosis and cirrhosis).…”

Section: Discussionmentioning

confidence: 99%

“…Modified Ferriman-Gallwey score was used to assess the degree of hirsutism. A score of ≥8 out of 36 was taken as significant 12 . Women were also examined for the presence of acanthosis nigricans, the severity of acne and extent of androgenic alopecia.…”

Section: Methodsmentioning

confidence: 99%

Fibroscan as a non-invasive predictor of hepatic steatosis in women with polycystic ovary syndrome

Chakraborty

Ganie

Masoodi

et al. 2020

Indian Journal of Medical Research

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Background & objectives: There is limited data on non-alcoholic fatty liver disease (NAFLD) among Indian women with polycystic ovary syndrome (PCOS), and there are no data on the utility of fibroscan in its assessment. The objective of this study was thus to investigate the frequency of hepatic steatosis in young women with PCOS and evaluate the utility of transient elastography (TE) in its assessment. Methods: Seventy women diagnosed with PCOS and 60 apparently healthy women (controls) were enrolled in this pilot study. These women were evaluated for clinical, biochemical and hormonal parameters, transabdominal ultrasonography, dual-energy X-ray absorptiometry and fibroscan assessing liver stiffness measure (LSM) and controlled attenuation parameter (CAP). Other indices such as liver fat score (LFS), lipid accumulation product (LAP), fibrosis-4 (FIB-4) and aspartate aminotransferase to platelet ratio index, hepatic steatosis index (HIS) scores were also calculated. The main outcome measures were the presence of NAFLD in women with PCOS and its correlation with CAP and LSM on TE. Results: Women with PCOS had higher frequency (38.57 vs. 6.67%) of hepatic steatosis than control women as determined by abdominal sonography. The aminotransferases were higher in PCOS group (14.28 vs. 1.7%, P =0.03) even after adjusting for body mass index implying higher non-alcoholic steatohepatitis among young PCOS patients. PCOS women had significantly higher CAP on TE compared to controls (210 vs. 196). CAP had a significant correlation with LFS, LAP and HIS. Interpretation & conclusions: NAFLD is common in young women with PCOS, and fibroscan using TE may be considered as a promising non-invasive diagnostic modality in its early detection.

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Oral glucose tolerance test significantly impacts the prevalence of abnormal glucose tolerance among Indian women with polycystic ovary syndrome: lessons from a large database of two tertiary care centers on the Indian subcontinent

Cited by 27 publications

References 54 publications

The value of the free androgen index depends on the phenotype of polycystic ovary syndrome — a single-centre experience

The value of the free androgen index depends on the phenotype of polycystic ovary syndrome — a single-centre experience

Association of Androgen Excess with Glucose Intolerance in Women with Polycystic Ovary Syndrome

Fibroscan as a non-invasive predictor of hepatic steatosis in women with polycystic ovary syndrome

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