scholarly journals Predictors of abnormal glucose metabolism in women with polycystic ovary syndrome

2006 ◽  
Vol 154 (2) ◽  
pp. 295-301 ◽  
Author(s):  
Matthias Möhlig ◽  
Joachim Spranger ◽  
Michael Ristow ◽  
Andreas F H Pfeiffer ◽  
Thilo Schill ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Receiver Operating Curve ◽  
Oral Glucose ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
Easy Method ◽  
Abnormal Glucose Metabolism

Objective: Polycystic ovary syndrome (PCOS) is a risk factor for type 2 diabetes mellitus and screening for abnormal glucose metabolism has been recommended by an oral glucose tolerance test (OGTT). This procedure is time-consuming and inconvenient, limiting its general use. Therefore, an easy method is wanted to separate PCOS women with normal from those with potentially abnormal glucose metabolism. Design: Simple parameters obtained from 101 consecutive PCOS patients were assessed by receiver operating curve analysis for their ability to predict abnormal glucose metabolism. Results: Comparing discriminating parameters at defined sensitivities revealed that, assessed by homeostasis model assessment (HOMA), insulin resistance (HOMA%S) had the highest specificitiy. At a cut-off point of 73.1%, HOMA%S had a sensitivity of 95.5% and a specificity of 51.9%. Applying this cut-off separated 59 women who had a high probability of abnormal glucose metabolism from 42 women who were at low risk (less than 2.5%). Fasting insulin was the second-best parameter and had a similar specificity. A screening strategy which applies HOMA%S or fasting insulin could almost halve the number of OGTTs by directing them to those PCOS women most likely to be suffering from abnormal glucose metabolism. The negative predictive value of this strategy was 97%. The strategy was tested and confirmed in a second and independent cohort of 264 PCOS women. Conclusions: HOMA%S, or to a lesser extent fasting insulin, appears to allow for stratified metabolic screening of PCOS women with OGTT.

scholarly journals Racial and Ethnic Differences in Metabolic Disease in Adolescents With Obesity and Polycystic Ovary Syndrome

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Stanley Andrisse ◽  
Yesenia Garcia-Reyes ◽  
Laura Pyle ◽  
Megan M Kelsey ◽  
Kristen J Nadeau ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
General Population ◽  
Polycystic Ovary Syndrome ◽  
Race And Ethnicity ◽  
Polycystic Ovary ◽  
Sex Hormone Binding Globulin ◽  
Oral Glucose ◽  
Model Assessment ◽  
Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity. Objective This work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth. Methods A secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (> 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity. Results Participants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone–binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (P = .002 overall, HW vs NHB [P = .009] vs NHW [P = 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (P = .010 overall, NHW vs NHB P = .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A1c (HbA1c) was lowest in NHW (overall P < .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P < .001 vs 5.7 ± 0.4%, P < .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P < .001) and prediabetes HbA1c 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P < .001) were different between the groups. Conclusion Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.

Bone Mineral Density is Unaltered in Women with Polycystic Ovary Syndrome

2018 ◽  
Vol 50 (10) ◽  
pp. 754-760 ◽  
Author(s):  
Mohd Ganie ◽  
Semanti Chakraborty ◽  
Ashish Sehgal ◽  
M. Sreejith ◽  
Devasenathipathy Kandasamy ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Bone Mineral ◽  
Young Women ◽  
Polycystic Ovary ◽  
Oral Glucose ◽  
Model Assessment ◽  
Mineral Density ◽  
Ovary Syndrome

Abstract Context The effects of endocrine aberrations associated with polycystic ovary syndrome (PCOS) on bone mineral density (BMD) in young women is a matter of debate. Objectives To compare BMD in young women with PCOS to age and body mass index (BMI) matched controls and to elucidate its correlation to BMI, insulin resistance and serum testosterone. Design and Methods We recruited 60 women with PCOS aged 14-24 years, diagnosed based on Rotterdam 2003 criteria, and 58 age matched controls. BMD was measured by dual energy X-ray absorptiometry. In addition, these subjects underwent biochemical and hormonal analysis including oral glucose tolerance test, calculation of Homeostatic Model Assessment–Insulin Resistance Index, measurement of serum thyroxine, thyrotropin, prolactin, total testosterone, dehydroepiandrosterone sulfate, follicular phase luteinizing hormone and follicle stimulating hormone. Results There was no difference of BMD between women with PCOS and control women (1.103±0.08 vs 1.126±0.083 g/cm2; p=0.122). In subgroup analysis based on BMI, BMD in obese women with PCOS was significantly higher than their overweight and lean counterparts at lumbar spine (p<0.001), neck of femur (p=0.005) and total hip (p<0.001). BMD was not different at any site between oligomenorrheic and non-oligomenorrheic women with PCOS. It positively correlated with BMI, waist and hip circumference in women with PCOS. No correlation was found with HOMA-IR or Testosterone. Conclusions BMI is the most important determinant of BMD in women with PCOS. BMD is not different between healthy young women and those with PCOS.

scholarly journals STUDY OF GLYCATED HEMOGLOBIN LEVELS IN POLYCYSTIC OVARY SYNDROME

2018 ◽  
Vol 11 (5) ◽  
pp. 191 ◽  
Author(s):  
Renuka Pangaluri ◽  
Shakthiya T ◽  
Vinodhini Vm
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Glycated Hemoglobin ◽  
Polycystic Ovary ◽  
Resistance Index ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Hba1c Levels

 Objective: Polycystic ovarian syndrome (PCOS) is often accompanied by insulin resistance, obesity, and cardiometabolic risk factors. Androgen excess-PCOS recommends oral glucose tolerance test or glycated hemoglobin (HbA1C) to evaluate dysglycemia in PCOS subjects. We undertook this study to evaluate the prevalence of elevated HbA1C levels in PCOS women.Methods: The study was carried out among 100 PCOS patients from SRM Hospital, 100 healthy individuals were included as controls. Fasting glucose, HbA1C, Insulin and Homeostasis Model Assessment-Insulin Resistance Index were estimated.Results: Patients with polycystic ovary syndrome showed a significant increase in HbA1C levels (5.799±1.022; 4.96±0.625, p=0.001) when compared to the control group.Conclusion: We found elevated HbA1C levels in PCOS women categorizing 26% as prediabetes and 28% as having type 2 diabetes mellitus.

scholarly journals Metformin improves polycystic ovary syndrome symptoms irrespective of pre-treatment insulin resistance

2007 ◽  
Vol 157 (5) ◽  
pp. 669-676 ◽  
Author(s):  
Susanne Tan ◽  
Susanne Hahn ◽  
Sven Benson ◽  
Tiina Dietz ◽  
Harald Lahner ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Fasting Glucose ◽  
Polycystic Ovary ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
Insulin Levels ◽  
Outcome Parameters ◽  
Pre Treatment

AbstractObjectiveInsulin resistance (IR) and obesity are common features of the polycystic ovary syndrome (PCOS). Insulin-sensitizing agents have been shown to improve both reproductive and metabolic aspects of PCOS, but it remains unclear whether it is also beneficial in lean patients without pre-treatment IR. The aim of this study was to determine the influence of metformin on the clinical and biochemical parameters of PCOS irrespective of the presence of basal obesity and IR.DesignThe effect of 6 months of metformin treatment was prospectively assessed in 188 PCOS patients, divided into three groups according to body mass index (BMI; lean: BMI<25 kg/m2, overweight: BMI 25–29 kg/m2, and obese: BMI≥30 kg/m2). Outcome parameters, which were also assessed in 102 healthy controls, included body weight, homeostasis model assessment for IR (HOMA-IR), fasting glucose and insulin levels, area under the curve of insulin response (AUCI), hyperandrogenism, and menstrual irregularities.ResultsIn comparison with the respective BMI-appropriate control groups, only obese but not lean and overweight PCOS patients showed differences in fasting insulin and HOMA-IR. Metformin therapy significantly improved all outcome parameters except fasting glucose levels. Subgroup analyses revealed that in the group of lean PCOS patients without pre-treatment IR, metformin significantly improved HOMA-IR (1.7±1.0 vs 1.1±0.7 μmol/l×mmol/l2) and fasting insulin levels (7.7±4.2 vs 5.4±3.9 mU/l), in addition to testosterone levels (2.6±0.9 vs 1.8±0.7 nmol/l), anovulation rate (2.3 vs 59.5%), and acne (31.8 vs 11.6%; all P<0.017). In the overweight and obese PCOS groups, metformin also showed the expected beneficial effects.ConclusionMetformin improves parameters of IR, hyperandrogenemia, anovulation, and acne in PCOS irrespective of pre-treatment IR or obesity.

scholarly journals Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome

2009 ◽  
Vol 161 (4) ◽  
pp. 575-582 ◽  
Author(s):  
E Wehr ◽  
S Pilz ◽  
N Schweighofer ◽  
A Giuliani ◽  
D Kopera ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Oral Glucose ◽  
Model Assessment ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Glucose Response ◽  
The Metabolic Syndrome

ObjectivesWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances, in particular from insulin resistance. Accumulating evidence suggests that vitamin D deficiency may contribute to the development of the metabolic syndrome (MS). Hence, the aim of our study was to investigate the association of 25(OH)D levels and the components of the MS in PCOS women.Methods25(OH)D levels were measured by means of ELISA in 206 women affected by PCOS. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.ResultsThe prevalence of insufficient 25(OH)D levels (<30 ng/ml) was 72.8% in women with PCOS. PCOS women with the MS had lower 25(OH)D levels than PCOS women without these features (17.3 vs 25.8 ng/ml respectively; P<0.05). In multivariate regression analysis including 25(OH)D, season, body mass index (BMI), and age, 25(OH)D and BMI were independent predictors of homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI; P<0.05 for all). In binary logistic regression analyses, 25(OH)D (OR 0.86, P=0.019) and BMI (OR 1.28, P<0.001) were independent predictors of the MS in PCOS women. We found significantly negative correlations of 25(OH)D levels with BMI, waist circumference, waist-to-hip ratio, systolic and diastolic blood pressure, fasting and stimulated glucose, area under the glucose response curve, fasting insulin, HOMA-IR, HOMA-β, triglycerides, and quotient total cholesterol/high-density lipoprotein (HDL) and positive correlations of 25(OH)D levels with QUICKI and HDL (P<0.05 for all).ConclusionWe demonstrate that low 25(OH)D levels are associated with features of the MS in PCOS women. Large intervention trials are warranted to evaluate the effect of vitamin D supplementation on metabolic disturbances in PCOS women.

Prevalence of abnormal glucose metabolism in a cohort of Arab women with polycystic ovary syndrome

2011 ◽  
Vol 114 (3) ◽  
pp. 288-289 ◽  
Author(s):  
Mohamed Y. Abdel-Rahman ◽  
Ahmad H. Abdellah ◽  
Salah R. Ahmad ◽  
Salah A. Ismail ◽  
Heidi Frasure ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Arab Women ◽  
Ovary Syndrome ◽  
Abnormal Glucose Metabolism

scholarly journals Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome

2011 ◽  
Vol 164 (5) ◽  
pp. 741-749 ◽  
Author(s):  
Elisabeth Wehr ◽  
Olivia Trummer ◽  
Albrecht Giuliani ◽  
Hans-Jürgen Gruber ◽  
Thomas R Pieber ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Oral Glucose ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Vitamin D Metabolism ◽  
Endocrine Parameters

IntroductionWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances including insulin resistance (IR), which might be related to vitamin D metabolism. We aimed to investigate the association of polymorphisms in the vitamin D receptor (VDR) gene as well as vitamin D level-associated genes with metabolic and endocrine parameters in PCOS women. Moreover, we examined whether there are associations with PCOS susceptibility.MethodsMetabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed in 545 PCOS and 145 control women. Genotyping of VDR (Cdx2, Bsm-I, Fok-I, Apa-I, and Taq-I), GC, DHCR7, and CYP2R1 polymorphisms was performed.Results25-Hydroxyvitamin D (25(OH)D) levels showed significant negative correlation with IR and positive correlation with insulin sensitivity (P<0.05 for all) in PCOS women. In PCOS women, the VDR Cdx2 ‘AA’ genotype was associated with lower fasting insulin (P=0.039) and homeostatic model assessment-IR (P=0.041) and higher quantitative insulin-sensitivity check index (P=0.012) and MATSUDA index (P=0.003). The VDR Apa-I ‘AA’ genotype was associated with lower testosterone (P=0.028) levels. In PCOS women, 170 women (31.2%) presented with 25(OH)D levels <20 ng/ml. PCOS women carrying the GC ‘GG’ genotype and the DHCR7 ‘GG’ genotype had a significantly higher risk for 25(OH)D levels <20 ng/ml (OR 2.53 (1.27–5.06), P=0.009, and OR 2.66 (1.08–6.55), P=0.033 respectively) compared with PCOS women carrying the GC ‘TT’ genotype and DHCR ‘TT’ genotype in multivariate analyses. We observed no association of genetic variations and PCOS susceptibility.ConclusionVDR and vitamin D level-related variants are associated with metabolic and endocrine parameters including 25(OH)D levels in PCOS women.

Lack of relationship between 17-hydroxyprogesterone response to buserelin testing and hyperinsulinemia in polycystic ovary syndrome

1997 ◽  
Vol 136 (4) ◽  
pp. 410-415 ◽  
Author(s):  
Yilmaz Şahin ◽  
Demet Ayata ◽  
Fahrettin Keleştimur
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Gnrh Agonist ◽  
Polycystic Ovary ◽  
Insulin Response ◽  
Prospective Clinical Study ◽  
Oral Glucose ◽  
Fasting Insulin ◽  
Ovary Syndrome ◽  
C Peptide ◽  
17 Hydroxyprogesterone

Abstract Objective: To determine whether hyperinsulinism affects cytochrome P450c 17α activity by investigating the correlation between 17–hydroxyprogesterone (17–OHP) hyper-responsiveness to the gonadotropin-releasing hormone (GnRH) agonist, buserelin, and the insulin response to oral glucose in polycystic ovary syndrome (PCOS). Design: Ultrasound, clinical and hormonal parameters were used to define PCOS in this prospective clinical study. We investigated the correlation between the 17–OHP response to buserelin testing and the insulin response to oral glucose in PCOS. Methods: Twenty-eight women with PCOS and eighteen normal women were included in the study. 17–OHP response to buserelin, and insulin and C–peptide responses to oral glucose were measured. Results: Twenty–live women with PCOS had an increased 17–OHP response. The PCOS patients showed significantly higher mean post–glucose load insulin and C–peptide levels than controls (P<0·05). No significant correlations were found between basal 17–OHP and fasting insulin or fasting C–peptide, between peak 17–OHP and fasting insulin, peak insulin or peak C–peptide, between 17–OHP area under the curve (AUC) and insulin AUC or C–peptide AUC, and between percent increment in 17–OHP and insulin AUC or C–peptide AUC (P >0·05). Conclusions: Lack of a relationship between the 17–OHP response to the GnRH agonist buserelin and hyperinsulinism suggests that hyperinsulinism may not play a role in the dysregulation of the cytochrome P450c17α enzyme seen in PCOS. European Journal of Endocrinology 136 410–415

scholarly journals Ghrelin levels are suppressed and show a blunted response to oral glucose in women with polycystic ovary syndrome.

2008 ◽  
Vol 158 (4) ◽  
pp. 511-516 ◽  
Author(s):  
Thomas M Barber ◽  
Felipe F Casanueva ◽  
Fredrik Karpe ◽  
Mary Lage ◽  
Stephen Franks ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Fat Mass ◽  
Polycystic Ovary ◽  
Geometric Mean ◽  
Oral Glucose ◽  
Model Assessment ◽  
Glucose Load ◽  
Fasting Serum ◽  
Ovary Syndrome ◽  
Serum Ghrelin

ObjectiveAbnormal ghrelin regulation may influence the development of obesity-associated conditions including polycystic ovary syndrome (PCOS). Our aim was to compare ghrelin regulation between PCOS cases and controls.DesignWe compared serum ghrelin (total) levels, fasting and 30-min post-oral (75 g) glucose load, between 50 PCOS cases and 28 female controls, including 22 body mass index (BMI)/fat mass-matched pairs. All subjects were of UK British/Irish origin.MethodsMeasurements included serum ghrelin (RIA technique (LINCO Research, St Charles MO, USA)), fat mass, serum testosterone, fasting serum insulin and plasma glucose levels. Insulin sensitivity was calculated as the homeostasis model assessment of insulin resistance (HOMA2 IR).ResultsFasting serum ghrelin levels were significantly lower in PCOS cases versus BMI/fat mass-matched controls (geometric mean (s.d. range), 1104 pg/ml (764–1595) vs 1756 pg/ml (1314–2347) respectively; P=2.3×10−4). Ghrelin suppression following oral glucose load was significantly blunted in PCOS cases versus BMI/fat mass-matched controls (geometric mean ghrelin suppression (s.d. range), 160 pg/ml (88–289) vs 424 pg/ml (220–818) respectively; P=2.0×10−4). Whole-group comparisons (50 PCOS cases versus 28 controls) adjusted for fat mass and age revealed similar results. In PCOS cases, there was a significant negative correlation between fasting serum ghrelin and HOMA2 IR (r2=−0.40, P=5.7×10−3). Following adjustment for HOMA2 IR, fat mass and age, comparisons between the whole groups of PCOS cases and controls revealed attenuated but significant differences in fasting serum ghrelin (P=1.3×10−3) and ghrelin suppression (P=1.8×10−3).ConclusionsIn women with PCOS, serum ghrelin levels are suppressed, showing a negative relationship with HOMA2 IR and a blunted response to oral glucose.

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