ROME — Oral glucose tolerance testing identified abnormal glucose metabolism in 10% more patients with polycystic ovary syndrome than did fasting glucose tests alone, a study has found.
Other clinical and paraclinical factors associated with type 2 diabetes were not highly predictive of impaired 2-hour glucose levels, suggesting that all patients with PCOS should be screened with an oral glucose tolerance test (OGTT), Dr. Simona Fica and her associates reported in a poster at the annual meeting of the European Association for the Study of Diabetes.
The 258 patients in the study had a mean age of 25 years and mean body mass index of 29 kg/m
Abnormal blood glucose levels were found in a total of 18.9% of the patients, with impaired fasting glucose in 5.4%, impaired glucose tolerance in 8.5%, and diabetes mellitus in 5%. Of the 247 patients with a fasting glucose level less than 126 mg/dL, OGTT revealed 10.1% with either impaired glucose tolerance (8.9%) or diabetes (1.2%) at 2 hours.
Abnormal 2-hour glucose values were significantly associated with an age of 30 years or older, a BMI of 27 or greater, a waist-hip ratio of 0.8 or greater, a fasting blood glucose value of 100 mg/dL or greater, a homeostasis model assessment index at or above 3, a total cholesterol level greater than 200 mg/dL, and triglyceride levels of 150 mg/dL or above.
However, the positive predictive value of these factors for abnormal 2-hour glucose values was low: 42.9% for fasting glycemia; 23.7% for triglycerides; and 13.4% for both BMI and waist-hip ratio, said Dr. Fica of the endocrinology department at Carol Davila University of Medicine and Pharmacy and Elias Hospital, both in Bucharest, Romania.
Neither the presence of acanthosis nigricans nor having first-degree relatives with type 2 diabetes was associated with 2-hour OGTT abnormalities in this population, despite the known association between the two factors and type 2 diabetes.
“Due to the low value of clinical and paraclinical data to predict 3-hour abnormal glucose levels, we suggest all patients be screened with OGTT,” they concluded.