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From the Clinical Research Centers |
Departments of Obstetrics and Gynecology (R.S.L., W.C.D.) and Health Evaluation Sciences (A.R.K.), Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033; and the Division of Women’s Health, Departments of Medicine and Obstetrics and Gynecology, Brigham and Women’s Hospital (A.D.), Boston, Massachusetts 02115
Address all correspondence and requests for reprints to: Andrea Dunaif, M.D., Division of Women’s Health, PBB-5, 75 Francis Street, Brigham and Women’s Hospital, Boston, Massachusetts 02115. E-mail: adunaif{at}bics.bwh.harvard.edu
Women with polycystic ovary syndrome (PCOS) are insulin resistant, have
insulin secretory defects, and are at high risk for glucose
intolerance. We performed this study to determine the prevalence of
glucose intolerance and parameters associated with risk for this in
PCOS women. Two-hundred and fifty-four PCOS women, aged 14–44 yr, were
prospectively evaluated at 2 centers, 1 urban and ethnically diverse
(n = 110) and 1 rural and ethnically homogeneous (n = 144).
The rural PCOS women were compared to 80 control women of similar
weight, ethnicity, and age. A 75-g oral glucose challenge was
administered after a 3-day 300-g carbohydrate diet and an overnight
fast with 0 and 2 h blood samples for glucose levels. Diabetes was
categorized according to WHO criteria. The prevalence of glucose
intolerance was 31.1% impaired glucose intolerance (IGT) and 7.5%
diabetes. In nonobese PCOS women (body mass index, <27
kg/m2), 10.3% IGT and 1.5% diabetes were found. The
prevalence of glucose intolerance was significantly higher in PCOS
vs. control women (
2 = 7.0;
P = 0.01; odds ratio = 2.76; 95% confidence
interval = 1.23–6.57). Variables most associated with
postchallenge glucose levels were fasting glucose levels
(P < 0.0001), PCOS status (P =
0.002), waist/hip ratio (P = 0.01), and body mass
index (P = 0.021). The American Diabetes
Association criteria applied to fasting glucose significantly
underdiagnosed diabetes compared to the WHO criteria (3.2%
vs. 7.5%; 2 = 4.7; P
= 0.046; odds ratio = 2.48; 95% confidence interval =
1.01–6.69). We conclude that 1) PCOS women are at significantly
increased risk for IGT and type 2 diabetes mellitus at all weights and
at a young age; 2) these prevalence rates are similar in 2 different
populations of PCOS women, suggesting that PCOS may be a more important
risk factor than ethnicity or race for glucose intolerance in young
women; and 3) the American Diabetes Association diabetes diagnostic
criteria failed to detect a significant number of PCOS women with
diabetes by postchallenge glucose values.
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M.L. Hendriks, J.C.F. Ket, P.G.A. Hompes, R. Homburg, and C.B. Lambalk Why does ovarian surgery in PCOS help? Insight into the endocrine implications of ovarian surgery for ovulation induction in polycystic ovary syndrome Hum. Reprod. Update, May 1, 2007; 13(3): 249 - 264. [Abstract] [Full Text] [PDF]
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 C. Gagnon and J.-P. Baillargeon Suitability of recommended limits for fasting glucose tests in women with polycystic ovary syndrome Can. Med. Assoc. J., March 27, 2007; 176(7): 933 - 938. [Abstract] [Full Text] [PDF]
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D. C.W. Lau Screening for diabetes in women with polycystic ovary syndrome Can. Med. Assoc. J., March 27, 2007; 176(7): 951 - 952. [Full Text] [PDF]
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X. Chen, D. Yang, L. Li, S. Feng, and L. Wang Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome Hum. Reprod., August 1, 2006; 21(8): 2027 - 2032. [Abstract] [Full Text] [PDF]
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T. Bridger, S. MacDonald, F. Baltzer, and C. Rodd Randomized Placebo-Controlled Trial of Metformin for Adolescents With Polycystic Ovary Syndrome Arch Pediatr Adolesc Med, March 1, 2006; 160(3): 241 - 246. [Abstract] [Full Text] [PDF]
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D. A. Ehrmann, D. R. Liljenquist, K. Kasza, R. Azziz, R. S. Legro, M. N. Ghazzi, and for the PCOS/Troglitazone Study Group Prevalence and Predictors of the Metabolic Syndrome in Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 48 - 53. [Abstract] [Full Text] [PDF]
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N. A. Cataldo, F. Abbasi, T. L. McLaughlin, M. Basina, P. Y. Fechner, L. C. Giudice, and G. M. Reaven Metabolic and ovarian effects of rosiglitazone treatment for 12 weeks in insulin-resistant women with polycystic ovary syndrome Hum. Reprod., January 1, 2006; 21(1): 109 - 120. [Abstract] [Full Text] [PDF]
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M. Urbanek, A. Woodroffe, K. G. Ewens, E. Diamanti-Kandarakis, R. S. Legro, J. F. Strauss III, A. Dunaif, and R. S. Spielman Candidate Gene Region for Polycystic Ovary Syndrome on Chromosome 19p13.2 J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6623 - 6629. [Abstract] [Full Text] [PDF]
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J. Vrbikova, K. Vondra, D. Cibula, K. Dvorakova, S. Stanicka, D. Sramkova, G. Sindelka, M. Hill, B. Bendlova, and J. Skrha Metabolic syndrome in young Czech women with polycystic ovary syndrome Hum. Reprod., December 1, 2005; 20(12): 3328 - 3332. [Abstract] [Full Text] [PDF]
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E. Diamanti-Kandarakis and C. Piperi Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth Hum. Reprod. Update, November 1, 2005; 11(6): 631 - 643. [Abstract] [Full Text] [PDF]
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F. Orio Jr., S. Palomba, T. Cascella, B. De Simone, F. Manguso, S. Savastano, T. Russo, A. Tolino, F. Zullo, G. Lombardi, et al. Improvement in Endothelial Structure and Function after Metformin Treatment in Young Normal-Weight Women with Polycystic Ovary Syndrome: Results of a 6-Month Study J. Clin. Endocrinol. Metab., November 1, 2005; 90(11): 6072 - 6076. [Abstract] [Full Text] [PDF]
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 P. Velasquez-Mieyer, S. Perez-Faustinelli, and P. A. Cowan Identifying Children at Risk for Obesity, Type 2 Diabetes, and Cardiovascular Disease Diabetes Spectr, October 1, 2005; 18(4): 213 - 220. [Abstract] [Full Text] [PDF]
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R. K. Danish and B. B. West Rapid Progression From Pre-diabetes to Severely Ill Diabetes While Under "Expert Care": Suggestions for Improved Screening for Disease Progression Diabetes Spectr, October 1, 2005; 18(4): 229 - 239. [Abstract] [Full Text] [PDF]
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I.A.A. Penna, P.R.B. Canella, R.M. Reis, M.F. Silva de Sa, and R.A. Ferriani Acarbose in obese patients with polycystic ovarian syndrome: a double-blind, randomized, placebo-controlled study Hum. Reprod., September 1, 2005; 20(9): 2396 - 2401. [Abstract] [Full Text] [PDF]
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M. Yilmaz, N. Bukan, R. Ersoy, A. Karakoc, I. Yetkin, G. Ayvaz, N. Cakir, and M. Arslan Glucose intolerance, insulin resistance and cardiovascular risk factors in first degree relatives of women with polycystic ovary syndrome Hum. Reprod., September 1, 2005; 20(9): 2414 - 2420. [Abstract] [Full Text] [PDF]
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 N. A Christy, A. S Franks, and L B. Cross Spironolactone for Hirsutism in Polycystic Ovary Syndrome Ann. Pharmacother., September 1, 2005; 39(9): 1517 - 1521. [Abstract] [Full Text] [PDF]
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I. Munir, H.-W. Yen, T. Baruth, R. Tarkowski, R. Azziz, D. A. Magoffin, and A. J. Jakimiuk Resistin Stimulation of 17{alpha}-Hydroxylase Activity in Ovarian Theca Cells in Vitro: Relevance to Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4852 - 4857. [Abstract] [Full Text] [PDF]
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S. Sam, R. S. Legro, R. Bentley-Lewis, and A. Dunaif Dyslipidemia and Metabolic Syndrome in the Sisters of Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4797 - 4802. [Abstract] [Full Text] [PDF]
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R. Azziz, C. Marin, L. Hoq, E. Badamgarav, and P. Song Health Care-Related Economic Burden of the Polycystic Ovary Syndrome during the Reproductive Life Span J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4650 - 4658. [Abstract] [Full Text] [PDF]
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D.H. Abbott, D.K. Barnett, C.M. Bruns, and D.A. Dumesic Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome? Hum. Reprod. Update, July 1, 2005; 11(4): 357 - 374. [Abstract] [Full Text] [PDF]
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Z. T. Bloomgarden Second World Congress on the Insulin Resistance Syndrome: Mediators, pediatric insulin resistance, the polycystic ovary syndrome, and malignancy Diabetes Care, July 1, 2005; 28(7): 1821 - 1830. [Full Text] [PDF]
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E. Codner, D. Mook-Kanamori, R. A. Bazaes, N. Unanue, H. Sovino, F. Ugarte, A. Avila, G. Iniguez, and F. Cassorla Ovarian Function during Puberty in Girls with Type 1 Diabetes Mellitus: Response to Leuprolide J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3939 - 3945. [Abstract] [Full Text] [PDF]
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M.A. Checa, A. Requena, C. Salvador, R. Tur, J. Callejo, J.J. Espinos, F. Fabregues, J. Herrero, and (Reproductive Endocrinology Interest Group of the Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome Hum. Reprod. Update, July 1, 2005; 11(4): 375 - 390. [Abstract] [Full Text] [PDF]
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R. S. Legro, C. L. Gnatuk, A. R. Kunselman, and A. Dunaif Changes in Glucose Tolerance over Time in Women with Polycystic Ovary Syndrome: A Controlled Study J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3236 - 3242. [Abstract] [Full Text] [PDF]
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B. L. Powell, L. Haddad, A. Bennett, N. Gharani, U. Sovio, C. J. Groves, K. Rush, M. J. Goh, G. S. Conway, A. Ruokonen, et al. Analysis of Multiple Data Sets Reveals No Association between the Insulin Gene Variable Number Tandem Repeat Element and Polycystic Ovary Syndrome or Related Traits J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2988 - 2993. [Abstract] [Full Text] [PDF]
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