Diagnosis of disorders of glucose tolerance in women with polycystic ovary syndrome (PCOS) at a tertiary care center: fasting plasma glucose or oral glucose tolerance test?

Ortiz-Flores, A.E.; Luque‐Ramírez, Manuel; Fernández‐Durán, Elena; Álvarez‐Blasco, Francisco; Escobar-Morreale, Héctor F.

doi:10.1016/j.metabol.2019.01.015

Cited by 20 publications

(13 citation statements)

References 49 publications

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“…Namely, it is proposed that the higher the FPG the greater the risk for IGT/T2DM (43). However, FPG was not able to accurately predict dysglycemia regardless of age, BMI, IR, and hyperandrogenemia in the present cohort, a finding corroborating that of a previous study (44).…”

Section: Discussionsupporting

confidence: 88%

Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS?

Livadas

Bothou

Kuliczkowska-Płaksej

et al. 2022

Endocrine Connections

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Background: Polycystic ovary syndrome (PCOS) is considered a risk factor for development of type 2 diabetes mellitus (T2DM). However, which is the most appropriate way to evaluate dysglycemia in women with PCOS and who are at increased risk are as yet unclear. Aim of the study: To determine the prevalence of T2DM, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in PCOS women, and potential factors to identify those at risk. Subjects and methods: The oral glucose tolerance test (OGTT), biochemical/hormonal profile, and ovarian ultrasound data from 1614 Caucasian women with PCOS and 362 controls were analyzed in this cross-sectional multicenter study. The data were categorized according to age and BMI. Results: Dysglycemia (T2DM, IGT, and IFG according to WHO criteria) was more frequent in the PCOS group compared to controls: 2.2% vs. 0.8%, p:0.04; 9.5% vs. 7.4%, p:0.038; and 14.2% vs. 9.1%, p:0.002, respectively. OGTT was essential for T2DM diagnosis, since in 88% of them basal glucose values were inconclusive for diagnosis. The presence of either T2DM or IFG was irrespective of age (p:0.54) and BMI (p:0.32), although the latter was associated with IGT (p: 0.021). There was no impact of age and BMI status on the prevalence of T2DM or IFG. Regression analysis revealed a role for age, BMI, fat deposition, androgens, and insulin resistance for dysglycemia. However, none of the factors prevailed as a useful marker employed in clinical practice. Conclusions: One-third of our cohort of PCOS women with either T2DM or IGT displayed normal fasting glucose values but without confirming any specific predictor for dysglycemic condition. Hence, the evaluation of glycemic status using OGTT in all women with PCOS is strongly supported.

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Section: Discussionsupporting

confidence: 88%

Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS?

Livadas

Bothou

Kuliczkowska-Płaksej

et al. 2022

Endocrine Connections

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“…In our study, we directly compared the performance of FPG, CVAI, VAI, LAP, TyG, WC, and BMI in detecting AGT and observed FPG demonstrated the lowest AUC value (0.695) and the lowest sensitivity (49.2%) among all the indices for detecting AGT. Thus, although FPG is an inexpensive assay and does not require mathematical calculations, it may not reliably detect AGT in our PCOS population, a nding consistent with previous studies [3,5].…”

Section: Discussionsupporting

confidence: 86%

“…Polycystic ovary syndrome (PCOS), a very common endocrine disorder, impacts 5-10% of women in their reproductive age [4]. A more meaningful screening for abnormal glucose tolerance (AGT) is warranted in women with PCOS as they show an increased prevalence of disturbances of glucose metabolism compared with the general population and have shown characteristically postprandial abnormalities in glucose metabolism [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Novel Obesity- and Lipid-Related Indices as Predictors of Abnormal Glucose Tolerance in Chinese Women with Polycystic Ovary Syndrome

Yin

Yan

Cao

et al. 2022

Preprint

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Purpose We aimed to evaluate the performance of Chinese visceral adiposity index (CVAI), visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) as indices in screening abnormal glucose tolerance (AGT) in Chinese women with polycystic ovary syndrome (PCOS), using the oral glucose tolerance test (OGTT) as a reference test. In addition, we essentially compared the abilities of these indices with body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG). Materials and Methods All 1113 PCOS patients evaluated in this study underwent OGTTs. The 2-h post-oral glucose load (2 h-PG) level was used to categorize subjects into two groups: those having AGT or normal glucose tolerance (NGT) levels. Results A statistically significant positive correlation between levels of 2 h-PG and FPG, BMI, WC, LAP, VAI, CVAI, TyG, (P < 0.05), was observed. The strongest correlation was found between the levels of 2 h-PG and CVAI (r = 0.469). The CVAI provided the highest area under the receiver-operating characteristic curve (AUC) for AGT, followed by LAP, BMI, TyG, VAI, WC, and FPG. The CVAI of 32.61 (with AUC: 0.758, sensitivity: 73.4%, specificity: 69.9%) was found to be the cut-off point for AGT in Chinese women with PCOS. Conclusions The CVAI may be used as a screening indicator of AGT in Chinese women with PCOS when there is no time or possibility to perform an OGTT.

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“…pre-diabetes, polycystic ovary syndrome (PCOS), IR without diabetes and metabolic syndrome (MetS)), including a comparison with circulating ZAG concentrations in metabolically healthy individuals, were retrieved from four electronic databases (PubMed, Medline, Web of Science and Scopus). The inclusion of PCOS as a form of dysglycaemia in this study is due to the higher level of IR, and increased risk of pre-diabetes and T2DM when compared to the general population ( 21 , 22 ). The search strategy combined keywords related to ZAG and T2DM (including common terms for dysglycaemia) (Supplementary Materials Section 3: Key words).…”

Section: Methodsmentioning

confidence: 99%

Zinc-alpha2-glycoprotein, dysglycaemia and insulin resistance: a systematic review and meta-analysis

Pearsey

Henson

Sargeant

et al. 2020

Rev Endocr Metab Disord

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To systematically review the current literature investigating associations between zinc-alpha2-glycoprotein (ZAG) and dysglycaemia (including type 2 diabetes (T2DM), poly-cystic-ovary syndrome (PCOS), pre-diabetes or insulin resistance). This included relationships between ZAG and continuous measures of insulin and glucose. Additionally, we performed a meta-analysis to estimate the extent that ZAG differs between individuals with or without dysglycaemia; whilst examining the potential influence of adiposity. A systematic search was performed on four databases for studies on circulating ZAG concentrations in adult human populations, comparing healthy controls to individuals with dysglycaemia. Key characteristics, including the mean ZAG concentrations (mg∙L−1), and any correlational statistics between ZAG and continuous measures of glucose, glycated haemoglobin (HbA1c) or insulin were extracted. Meta-analyses were performed to compare metabolically healthy controls to cases, and on studies that compared controls and cases considered overweight or obese (body mass index (BMI) ≥25 kg.m2). 1575 papers were identified and 14 studies (16 cohorts) were considered eligible for inclusion. Circulating ZAG was lower in individuals with dysglycaemia compared to metabolically healthy controls (−4.14 [−8.17, −0.11] mg.L−1; I2 = 98.5%; p < 0.001). When using data from only studies with overweight or obese groups with or without dysglycaemia (three studies (four cohorts); pooled n = 332), the difference in circulating ZAG was no longer significant (−0.30 [−3.67, 3.07] mg. L−1; I2 = 28.0%; p = 0.225). These data suggest that ZAG may be implicated in dysglycaemia, although there was significant heterogeneity across different studies and the mediating effect of adiposity cannot be excluded. Therefore, more research is needed before robust conclusions can be drawn.

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Diagnosis of disorders of glucose tolerance in women with polycystic ovary syndrome (PCOS) at a tertiary care center: fasting plasma glucose or oral glucose tolerance test?

Cited by 20 publications

References 49 publications

Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS?

Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS?

Evaluation of Novel Obesity- and Lipid-Related Indices as Predictors of Abnormal Glucose Tolerance in Chinese Women with Polycystic Ovary Syndrome

Zinc-alpha2-glycoprotein, dysglycaemia and insulin resistance: a systematic review and meta-analysis

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