Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.

Ehrmann, David A.; Barnes, Randall B.; Rosenfield, Robert L.; Cavaghan, Melissa K.; Imperial, Jacqueline

doi:10.2337/diacare.22.1.141

Cited by 1,149 publications

(824 citation statements)

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“…Women with PCOS often suffer from obesity, insulin resistance, IGT, or type 2 diabetes [14][15][16][17]41]. In our cohort of 118 consecutive PCOS women with a mean age of approximately 29 years, 21% were diagnosed with either IGT or type 2 diabetes, according to the 2-h glucose concentration of an OGTT.…”

Section: Discussionmentioning

confidence: 98%

“…Furthermore, insulin resistance is proposed to be a major risk factor for the development of type 2 diabetes mellitus and subsequent cardiovascular disease [10][11][12][13]. Estimates from several studies indicate that approximately 20-40% of adult and adolescent PCOS women, including both lean and obese patients, suffer from impaired glucose metabolism (IGM, defined as impaired glucose tolerance or type 2 diabetes) [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…However, several studies demonstrate that a substantial proportion of PCOS women with IGT or even type 2 diabetes show normal fasting glucose concentrations [14,16,17]. It has therefore been suggested that all PCOS patients should undergo an OGTT for detection of IGM [13].…”

Section: Introductionmentioning

confidence: 99%

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Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling

et al. 2006

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Aims/hypothesis Polycystic ovary syndrome (PCOS) is a risk factor of type 2 diabetes. Screening for impaired glucose metabolism (IGM) with an OGTT has been recommended, but this is relatively time-consuming and inconvenient. Thus, a strategy that could minimise the need for an OGTT would be beneficial. Materials and methods Consecutive PCOS patients (n=118) with fasting glucose <6.1 mmol/l were included in the study. Parameters derived from medical history, clinical examination and fasting blood samples were assessed by decision tree modelling for their ability to discriminate women with IGM (2-h OGTT value ≥7.8 mmol/l) from those with NGT. Results According to the OGTT results, 93 PCOS women had NGT and 25 had IGM. The best decision tree consisted of HOMA-IR, the proinsulin:insulin ratio, proinsulin, 17-OH progesterone and the ratio of luteinising hormone: follicle-stimulating hormone. This tree identified 69 women with NGT. The remaining 49 women included all women with IGM (100% sensitivity, 74% specificity to detect IGM). Pruning this tree to three levels still identified 53 women with NGT (100% sensitivity, 57% specificity to detect IGM). Restricting the data matrix used for tree modelling to medical history and clinical parameters produced a tree using BMI, waist circumference and WHR. Pruning this tree to two levels separated 27 women with NGT (100% sensitivity, 29% specificity to detect IGM). The validity of both trees was tested by a leave-10%-out cross-validation. Conclusions/interpretation Decision trees are useful tools for separating PCOS women with NGT from those with IGM. They can be used for stratifying the metabolic screening of PCOS women, whereby the number of OGTTs can be markedly reduced.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling

et al. 2006

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“…Polycystic ovary syndrome (PCOS) is a common clinical disorder affecting 5 %-10 % of young women [12]. The disorder is associated with hirsutism, obesity and multiple cysts in the ovaries [13].…”

Section: Discussionmentioning

confidence: 99%

Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome

Peng

Guo

Long

et al. 2012

J Assist Reprod Genet

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Background The purpose of this study was to determine the incidence of premature luteinization in patients with polycystic ovary syndrome and compared the main determinants of success in in-vitro fertilization in PCOS patients with and without premature luteinization. Methods Retrospective analysis of 180 PCOS women of Chinese Han origin with infertility who underwent controlled ovarian hyperstimulation (COH) with an exogenous gonadotropin/GnRH antagonist protocol. Hormone levels on the hCG day and IVF outcomes were assessed. Results The incidence of premature luteinization was 23.3 %. Compared with PCOS patients without premature luteinization, PCOS patients with premature luteinization (PL) had a higher number of oocytes retrieved (18.20±6.6 vs 15.08±7.3, p00.037) and a higher fertilization rate (72.9± 1.9 vs63.1±2.3, p00.033), but clinical pregnancy rates were no statistical significance (53.3 vs 56.0, p00.836). Though the implantation rate was higher in no premature luteinization patients, but the difference was not statistically significant (37.7 vs 30.3, p00.115). Conclusion The PCOS patients with premature luteinization had a higher fertilization rate and high number of oocytes retrieved, and the similar implantation rate and clinical PRs as PCOS patients without premature luteinization.

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“…Indeed, the prevalence of impaired glucose tolerance (IGT) in obese young women with PCOS has been estimated to be as high as 30-40%, with an additional 5-10% having frank diabetes. 12,13 The current 'epidemic' of obesity therefore has very serious implications for the long-term health of women with PCOS. Particularly worrying is the rising tide of childhood obesity that has resulted in an increase in the prevalence and severity of symptoms of PCOS in adolescent girls (see below), although it is unlikely that the prevalence of polycystic ovaries is increasing.…”

Section: Introductionmentioning

confidence: 99%

Polycystic ovary syndrome in adolescents

2008

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Background: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women and typically presents during adolescence. The clinical and biochemical presentation is heterogeneous, but elevated serum concentrations of androgens are the most consistent biochemical abnormality and may be considered to be the hallmark of the syndrome. Many women with PCOS also have insulin resistance and hyperinsulinaemia, which may contribute to the clinical and endocrine abnormalities. The aetiology of PCOS is not clear but studies in the Rhesus monkey suggest that exposure to excess androgen during intrauterine life results in many of the features of human PCOS, including ovarian dysfunction, abnormal LH secretion and insulin resistance. Objective: To review the studies from the literature, including those of the author, regarding aetiology, presentation and management of PCOS in adolescents. Results and conclusions: We have proposed that PCOS in adolescents arises as a result of a genetically determined disorder of ovarian function that results in hyper-secretion of androgens, possibly during fetal life and also during physiological activation of the hypothalamic-pituitary-ovarian in infancy and at the onset of puberty. There is plentiful evidence for a genetic basis for PCOS (it appears to be a complex endocrine disorder resulting from the effects of a several genes), but environmental factors, notably nutrition, influence the clinical and biochemical phenotype. Obesity unmasks or amplifies symptoms, endocrine and metabolic abnormalities. The increasing incidence of childhood obesity has resulted in an alarming Increase not only in distressing symptoms but also impaired glucose tolerance and even diabetes among adolescent girls with PCOS. The search for PCOS genes in this condition, that is not only heterogeneous but also presents only in women of reproductive age, is not straightforward and has produced few convincing candidates so far. In due course, however, identification of the major susceptibility loci is likely to provide key insight into the aetiology of the syndrome and improve diagnosis and management.

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Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.

Cited by 1,149 publications

References 0 publications

Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling

Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling

Progesterone levels on the hCG day and outcomes in vitro fertilization in women with polycystic ovary syndrome

Polycystic ovary syndrome in adolescents

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