Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome

Weerakiet, Sawaek; Srisombut, Chartchai; Bunnag, Pongamorn; Sangtong, S; Chuangsoongnoen, N; Rojanasakul, A

doi:10.1016/s0020-7292(01)00477-5

Cited by 107 publications

(97 citation statements)

References 17 publications

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“…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. This prevalence is similar to results reported for other PCOS cohorts of comparable age [15,16,41], and is significantly higher than the IGM prevalence in the general population [42]. Hence, screening of PCOS women for IGM has been recommended [13,17,19].…”

Section: Discussionsupporting

confidence: 84%

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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: Discussionsupporting

confidence: 84%

“…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: 99%

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

et al. 2006

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“…In the study by Legro et al, 73% had a BMI ≥ 27 kg/m 2 (2), while in Thailand, only 26.6% of the study subjects were obese, in the same age range (15). As we observed, for FPG, a higher prevalence of AGM was attained using the WHO criteria.…”

Section: Discussionmentioning

confidence: 44%

“…A higher prevalence of glucose intolerance in PCOS patients according to the WHO criteria was also seen in a group of 79 patients from Thailand (IGT: 20.3%; DM: 9.5%) (15). However, when the fasting blood glucose was assessed according to the ADA criteria, the prevalence of IFG decreased to 3.8% and the prevalence of DM decreased to 6.3%.…”

Section: Discussionmentioning

confidence: 76%

“…Similar results were observed by Legro et al, by the WHO criteria, although in a more advanced age range (> 40 yr). In the study of Weerakiet et al, from Thailand (15), the smaller prevalence of AGM according to WHO criteria was seen for patients less than 20 years of age (2.5%) and increased up to 11.4% in the other age ranges, without a clear influence for each age range. An important bias regarding these data is the lower number of patients in more advanced age range.…”

Section: Discussionmentioning

confidence: 88%

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Prevalence of abnormalities of glucose metabolism in patients with polycystic ovary syndrome

Barcellos

Rocha

Hayashida

et al. 2007

Arq Bras Endocrinol Metab

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Patients with polycystic ovary syndrome (PCOS) present a higher risk for abnormalities of glucose metabolism (AGM). For to study this in our population, we submitted 85 patients, with body mass index (BMI) of 28.5 ± 6.6 kg/m 2 and aged 25.5 ± 5.4 years old, to an oral glucose tolerance test (OGTT), and assessed the impact of BMI on the prevalence of impaired glucose tolerance (IGT) and of diabetes mellitus (DM). The states of glucose tolerance were classified considering fasting plasma glucose (FPG) according to the American Diabetes Association (ADA) criterion and plasma glucose at 120 minutes according to the Word Health Organization (WHO) criterion. According to the ADA criteria, 83.5% classified as normal and 16.5% as with AGM, with 15.3% presenting impaired fasting glucose and 1.2% DM, while according to the WHO criteria, 68.2% were classified as normal and 31.8% as with AGM, with 27.0% of them presenting IGT and 4.8% DM. Seventy-three percent of PCOS patients with IGT by WHO criterion had normal FPG by ADA criterion. The prevalence of AGM for both criteria increased with the body mass index. In conclusion, we found a higher prevalence of AGM in PCOS patients than that found in the general population, being the highest in obese patients. Glycemia at 120 minutes on the OGTT identified more patients with AGM than fasting glycemia. We recommended that the assessment of AGM must be done by the OGTT in all patients with PCOS. RESUMO Prevalência de Anormalidades do Metabolismo de Glicose em Pacientes com a Síndrome dos Ovários Policísticos.Pacientes com a síndrome dos ovários policísticos (SOP) têm um risco maior para desenvolver anormalidades do metabolismo da glicose (AMG). Para avaliarmos a prevalência dessas anormalidades na nossa população, submetemos 85 pacientes, com índice de massa corporal (IMC) de 28,5 ± 6,6 kg/m 2 e média etária de 25,5 ± 5,4 anos, a teste de tolerância oral à glicose (TTOG). Os estados de tolerância à glicose foram classificados considerando a glicemia de jejum (GJ; American Diabetes Association -ADA) e glicemia aos 120 minutos (G120; Organização Mundial de Saúde -OMS). De acordo com a ADA, 83,5% das pacientes foram normais e 16,5% com AMG, com 15,3% apresentando glicemia de jejum imprópria e 1,2% diabetes mellitus (DM). De acordo com a OMS, 68,2% foram normais e 31,8% com AMG, com 27,0% apresentando intolerância à glicose (IG) e 4,8% DM. Observamos que 73% das pacientes com IG pelos critérios da OMS apresentavam GJ normal pelos critérios da ADA. A prevalência de AMG para ambos os critérios foi maior entre as pacientes com IMC mais elevado. Conclusão: encontramos maior prevalência de AMG nas pacientes com a SOP do que na população geral, sendo mais elevada entre as pacientes obesas. Além disso, a G120 no TTOG identificou maior número de pacientes com AMG do que a GJ. Assim, recomendamos avaliação de AMG através do TTOG para todas as pacientes portadoras da SOP.

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Sex Differences of Endogenous Sex Hormones and Risk of Type 2 Diabetes

Ding¹,

Song²,

Malik³

et al. 2006

JAMA

1,243

983

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Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome

Abstract: Similar to other ethnic populations, Asian women with PCOS are at risk of developing IGT and type 2 DM especially if obese. The recommendation of the ADA is not appropriate for the diagnosis of type 2 DM in PCOS women.

Cited by 107 publications

References 17 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

Prevalence of abnormalities of glucose metabolism in patients with polycystic ovary syndrome

Sex Differences of Endogenous Sex Hormones and Risk of Type 2 Diabetes

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