Prevalence of glucose tolerance test abnormalities in women with polycystic ovarian syndrome
Keywords:PCOS, Oral glucose tolerance test abnormalities, Impaired glucose tolerance, Non-insulin dependent diabetes mellitus
Background: PCOS is the most frequent endocrine disorder, often complicated by chronic anovulatory infertility and hyperandrogenism. High prevalence of impaired glucose tolerance and type 2 diabetes is observed due to peripheral insulin resistance. Holistic approach to the disorder to prevent long-term complications is required. The objective of the study was to study the prevalence of oral glucose tolerance test abnormalities (OGTT) in PCOS women and to study the significance of risk factors contributing to glucose intolerance in women with PCOS.
Methods: Hospital based analytical cross sectional study was conducted for 1 and ½ years among 200 women with PCOS. Women diagnosed as PCOS according to Rotterdam’s criteria. Women with other causes of anovulation, premature ovarian failure and women already diagnosed to be diabetic.
Results: Abnormal glucose tolerance was observed in 32 (16 %) of the 200 PCOS women. Among them 14.5% had impaired glucose tolerance (IGT) and 1.5% had diabetes. There was a significant trend towards increasing prevalence of IGT and diabetes in females with higher BMI, waist circumference, clinical and biochemical hyperandrogenism and patients with metabolic syndrome.Conclusions: High prevalence of IGT and Non-Insulin Dependent Diabetes Mellitus (NIDDM) in women with PCOS was observed than expected. They have accelerated conversion from IGT to NIDDM. IGT is often asymptomatic and is a known risk factor for type 2 DM and cardiovascular disease. OGTT with 75 gms of glucose is the best screening method for glucose intolerance and a good measure to diagnose type 2 DM in PCOS women.
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89:2745-9.
Diamanti – Kandarakis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84:4006-11.
Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434-8.
Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83:3078-82.
Burghen G A, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab. 1980;50:113-6.
Fauser B, Tarlatz B, Chang J, Azziz R, Legro C, Dewailly D, et al. The Rotterdam ESHRE/ ASRM sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41-7.
Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440-7.
Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: International consensus definitions. Hum Reprod Update. 2003;9:505-14.
American Diabetes Association. Standards of medical care in diabetes-2015. Diabetes Care. 2015;38(suppl 1):S1-93.
Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indiansand recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009;57:163-70.
Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J 1999 Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141-6.
Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84:165-9.
Dabadghao P, Roberts BJ, Wang J, Davies MJ. Glucose Tolerance abnormalities in Australian women with polycystic ovary syndrome. MJA. 2007;187:328-31.
Kanchana Devi B, Arputha Mary N, Radha Pandiyan, Pandian N. Prevalence of Glucose Tolerance Test abnormalities in South Indian Sub-fertile women. Chettinad Health CityMedical Journal. 2015;4(1):20-3.
Palmert MR, Gordon CM, Kartashov AI, Legro RS, Emans SJ, Dunaif A. Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome. J Clin Endocrinol Metab. 2002;87:1017-23.
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM. Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention. N Engl J Med. 2002;346:393-403.
Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2010;16(4):347-63.