The prevalence of Type 2 diabetes is not increased in normal-weight women with PCOS

Pelanis, Rasa; Mellembakken, Jan Roar; Sundström‐Poromaa, Inger; Ravn, Pernille; Morin‐Papunen, Laure; Tapanainen, Juha S.; Piltonen, Terhi; Puurunen, Johanna; Hirschberg, Angelica Lindén; Fedorcsák, Péter; Andersen, Marianne; Glintborg, Dorte

doi:10.1093/humrep/dex294

Cited by 43 publications

(60 citation statements)

References 34 publications

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“…On the other hand, authors of several longitudinal studies demonstrate that the risk of T2DM in women with PCOS is linked mainly to overweight, to obesity, or to weight gain through the life 66,74,92,101,103. Similar results were achieved by Pelanis et al, who in a Nordic cross-sectional study found that no normal-weight woman with PCOS had been diagnosed with T2DM 125. On the basis of these observations, it can be suggested that routine OGTT may not be indicated in normal-weight women with PCOS.…”

supporting

confidence: 61%

“…On the basis of these observations, it can be suggested that routine OGTT may not be indicated in normal-weight women with PCOS. The recommendations of OGTT in women with diagnosed PCOS vary between different guidelines, in frequency of testing and selection of the people included to the screening, depending on their age, BMI, previous gestational diabetes mellitus, or family history of T2DM, that was comprehensively described by Pelanis et al125 Some authors convince that not all patients with PCOS should be screened for T2DM and that OGTT could be performed only in high-risk patients, that was already submitted by Glintborg and Andersen 126. Authors of the actual analysis support the opinion postulated by Torchen in a recently published review,111 that screening for T2DM is needed in all patients with PCOS, as there are longitudinal observations that even normal-weight PCOS women are at increased risk of abnormal glucose metabolism.…”

mentioning

confidence: 99%

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Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Jacewicz-Święcka

Kowalska

2018

Diabetes Metabolism Res

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The purpose of this study was to perform a review of the longitudinal studies to determine whether polycystic ovary syndrome is associated with higher prevalence of metabolic complications and cardiovascular morbidity and mortality. The primary outcomes included body mass index, metabolic syndrome and its components (waist circumference, lipid profile, arterial hypertension, abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes), insulin resistance, and cardiovascular diseases like stroke, angina, and coronary heart disease. Complications in pregnant women were beyond the scope of this review. PubMed database (1992-2018) was searched to identify proper publications. Finally, data from 47 articles were analysed. Studies differed in the design (prospective, retrospective, cohort, observational), research methods, polycystic ovary syndrome diagnostic criteria, studied populations, race, and ethnicity of the participants. Based on the data collected, it appears that women with polycystic ovary syndrome have higher prevalence of obesity, abdominal fat distribution, dyslipidaemia and deterioration of glucose metabolism, but increased prevalence of cardiovascular diseases is not proven.

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supporting

confidence: 61%

mentioning

confidence: 99%

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Jacewicz-Święcka

Kowalska

2018

Diabetes Metabolism Res

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Section: Discussionsupporting

confidence: 70%

“…Although numerous studies have found that testosterone is closely associated with insulin resistance and could further lead to diabetes, no obvious correlations were found between testosterone and FPG, 2hPG or HbA1c in the present study, which was consistent with a Nordic multicentre cross-sectional study. 30 However, it should be noted that the measurement of low serum aldosterone concentrations by LC-MS/MS remains a challenge, despite being a relatively more accurate and reliable method when compared with immunoassays. [32][33][34] Although no clear causality between steroid hormones and abnormal glucose metabolism was proven in our study, increasing evidences indicate that abnormal patterns of steroid hormones, such as hyperandrogenaemia and hyperaldosteronaemia in women with PCOS, contribute to hyperglycaemia and may increase the risk of prediabetes and T2DM.…”

Section: Discussionmentioning

confidence: 99%

“…In the PCOS population of the two centres, the median age of patients was 26 years (IQR: [21][22][23][24][25][26][27][28][29][30], and the median BMI was 28.93 kg/ m 2 (IQR: 24. 16-33.20 The women with abnormal glucose metabolism, which included prediabetes and T2DM, were older and had a higher BMI and WHR than those with normal glucose metabolism.…”

Section: Clinical and Metabolic Characteristics And Serum Steroid Hmentioning

confidence: 99%

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Correlation between glucose metabolism and serum steroid hormones in patients with polycystic ovary syndrome

Zhang

et al. 2020

Clinical Endocrinology

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Objective Polycystic ovary syndrome (PCOS) is associated with an increased prevalence of dysglycaemia, which includes impaired glucose tolerance and type 2 diabetes mellitus (T2DM). Patients with PCOS demonstrate abnormal patterns of steroid hormones. Here, we analyse the correlation between glucose metabolism and serum steroid hormones in PCOS. Design Observational double‐centre study. Patients 914 patients with PCOS. Measurements We assessed the glucose metabolism status of all patients according to the 1999 WHO criteria. Serum steroid hormones were measured by liquid chromatography‐tandem mass spectrometry. Results The median age of the patients was 26 years (interquartile range: 21‐30), and 40.6% (371/914) had abnormal glucose metabolism: 29.3% (268/914) had prediabetes, and 11.3% (103/914) had T2DM. Correlation analysis not adjusting for confounding factors revealed that serum aldosterone, androstenedione, oestrone, pregnenolone and the free androgen index were positively correlated, while progesterone was negatively correlated with the risk of abnormal glucose metabolism. After adjusting for age, body mass index and fasting insulin levels in the logistic regression model, only aldosterone (P = .013), androstenedione (P = .046) and oestrone (P = .014; in quartiles) were correlated with the risk of abnormal glucose metabolism. Conclusions This study indicates a high prevalence of prediabetes and T2DM in patients with PCOS. Furthermore, there were positive correlations of serum aldosterone, androstenedione and oestrone with the risk of abnormal glucose metabolism after adjusting for confounding factors.

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Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome

Krentowska

Kowalska

2021

Diabetes Metabolism Res

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Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-age women. Important factors in its pathogenesis are hyperinsulinaemia and insulin resistance, which lead to higher risk of metabolic syndrome (MetS) and its complications. With the implementation of the Rotterdam diagnostic criteria in 2003, the group of PCOS patients became highly heterogeneous, with varying metabolic risk reported for different phenotypes of the syndrome. The aim of the present review is to assess the prevalence and severity of MetS and its components in patients with the four phenotypes of PCOS. A comprehensive search of Pubmed database was performed to identify studies comparing metabolic characteristics between PCOS patients with different phenotypes of the syndrome. The results of 60 studies published between 2004 and 2020 were retrieved and analysed. More adverse metabolic profile was observed in PCOS patients with hyperandrogenic phenotypes in comparison to normoandrogenic patients, as well as in classic phenotypes, defined by National Institutes of Health criteria, in comparison to newer phenotypes introduced by the Rotterdam criteria. In the majority of observations, normoandrogenic PCOS patients did not differ significantly from controls in terms of metabolic characteristics, although some East Asian studies reported more adverse metabolic profile in normoandrogenic phenotype in comparison to healthy women. In conclusion, metabolic abnormalities in PCOS seem to be associated with joint effects of hyperandrogenism, insulin resistance and visceral obesity. The differences observed between the four phenotypes of PCOS underline the need for individualised diagnostic and therapeutic approach.

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The prevalence of Type 2 diabetes is not increased in normal-weight women with PCOS

Abstract: N/A.

Cited by 43 publications

References 34 publications

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Correlation between glucose metabolism and serum steroid hormones in patients with polycystic ovary syndrome

Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome

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