Exp Clin Endocrinol Diabetes 2004; 112 - P139
DOI: 10.1055/s-2004-819258

Risk indicators for glucose intolerance in PCOS women with fasting normoglycemia

M Möhlig 1, J Spranger 1, AFH Pfeiffer 1, G Brabant 2, C Schöfl 2
  • 1Department of Clinical Nutrition, German Institute of Human Nutrition, Potsdam-Rehbrücke and Department of Endocrinology, Diabetes and Nutrition, Charité-University Medicine Berlin, Campus Benjamin Franklin, Berlin
  • 2Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover

The syndrome of polycystic ovaries (PCOS) is a known risk factor for type 2 diabetes mellitus (DM). As the clinical symptoms of PCOS (e.g. hirsutism and menstrual irregularities) are easily recognized, this group of patients is ideal for strategies focusing on prevention and early diagnosis of altered glucose metabolism. The purpose of this study was to define a risk indicator for glucose intolerance in PCOS women with fasting normoglycemia.

Methods: 60 women with PCOS (age 28.9±4.7, BMI 30.2±7.8kg/m2) with fasting normoglycemia (79±12mg/dl) were prospectively assessed for glucose intolerance (OGTT), features of the metabolic syndrome (MS), and for insulin resistance (HOMA). Normal (NGT), impaired glucose tolerance (IGT) and DM was defined according to WHO criteria. Patients were diagnosed as suffering from MS if WHO or ATP III criteria were met, and HOMA less than 70% was regarded as insulin resistant. Associations between variables was calculated by Fisher’s exact test.

Results: The OGTT revealed NGT in 50 patients (83%), 7 women had IGT (12%), and 3 (5%) already suffered from DM. In 20 women (32%) MS was diagnosed and 25 (42%) were found to be insulin resistant. Both MS (p=0.01) and insulin resistance (p=0.001) were associated with altered glucose metabolism (IGT and DM). However, 2 women with IGT and 1 with DM had no MS whereas only 1 patient with IGT but none with DM was classified as insulin sensitive. The sensitivity and specificity to detect glucose intolerance were 90% and 68% for HOMA, and 70% and 74% for MS. The positive and negative predictive values were 36% and 97% for HOMA and 35% and 92% for MS.

Conclusion: A considerable proportion of young women with PCOS and fasting normoglycemia suffer from IGT or DM according to WHO criteria. Insulin resistance as judged by HOMA appears to be a reasonable and feasible risk indicator to stratify for further diagnostic procedures in these women.