Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Lerchbaum, E; Schwetz, V; Giuliani, A; Obermayer-Pietsch, B.
Assessment of glucose metabolism in polycystic ovary syndrome: HbA1c or fasting glucose compared with the oral glucose tolerance test as a screening method.
Hum Reprod. 2013; 28(9):2537-2544
Doi: 10.1093/humrep/det255
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- Führende Autor*innen der Med Uni Graz
- Lerchbaum Elisabeth
- Co-Autor*innen der Med Uni Graz
- Giuliani Albrecht
- Obermayer-Pietsch Barbara
- Theiler-Schwetz Verena
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- Abstract:
- Are HbA1c and fasting glucose (FG) useful in predicting the presence of prediabetes and type 2 diabetes (T2DM) in a large cohort of women with polycystic ovary syndrome (PCOS)? HbA1c and FG are not suitable as screening tools for prediabetes in a large cohort of PCOS women but do show a good level of agreement with T2DM. Women with PCOS have an increased risk of prediabetes and T2DM. As performing an oral glucose tolerance test (OGTT) is time consuming, HbA1c and FG have been suggested as screening tools for prediabetes and T2DM. This was a cross-sectional study of 671 women with PCOS conducted from 2006 to 2012. The study was carried out at the endocrinological outpatient department of the Medical University of Graz, Austria. We performed 75 g 2-h OGTTs and measured HbA1c in 671 women with PCOS aged 16-45 years with a median BMI of 24.2 (21.3-30.1) kg/m². PCOS was defined according to the Rotterdam criteria. Prediabetes (FG 100-125 mg/dl and/or 2-h glucose 140-199 mg/dl and/or HbA1c 5.7-6.4%) and T2DM (FG ≥ 126 mg/dl and/or 2-h glucose ≥200 mg/dl and/or HbA1c ≥ 6.5%) were diagnosed according to the American Diabetes Association (ADA) criteria. Levels of agreement between different definitions were analyzed using κ-index. According to the ADA criteria, we found prediabetes and T2DM in 12.8% (n = 76) and 1.5% (n = 9) of PCOS women, respectively. When using elevated HbA1c (5.7-6.4%) for defining prediabetes, 19 (3.2%) of all PCOS women had prediabetes with a κ-index of 0.36. When using elevated FG (100-125 mg/dl) for defining prediabetes, 31 (5.2%) of all the PCOS women were diagnosed with prediabetes with a κ-index of 0.05. Further, elevated HbA1c (≥6.5% defining T2DM) was found in six (0.9%) PCOS women (κ-index 0.80), and elevated FG (≥126 mg/dl diagnosing T2DM) was found in seven PCOS women (1%; κ-index 0.82). Our results are limited to an Austrian cohort of PCOS women diagnosed by Rotterdam criteria with a median BMI in the normal weight range. Our results are in line with results from previous smaller PCOS cohorts. Our findings do not support the recommendation that FG or HbA1c can be used for the screening of prediabetes in women with PCOS. For such women, OGTT should be performed for screening of prediabetes. Whether this finding is generalizable to other cohorts remains to be determined in further studies.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Adult - epidemiology
- Blood Glucose - analysis
- Body Mass Index -
- Cohort Studies -
- Cross-Sectional Studies -
- Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology
- Female -
- Glucose Tolerance Test -
- Hemoglobin A, Glycosylated - analysis
- Hospitals, University -
- Humans -
- Mass Screening - methods
- Middle Aged -
- Outpatient Clinics, Hospital -
- Overweight - complications
- Polycystic Ovary Syndrome - blood Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - metabolism Polycystic Ovary Syndrome - physiopathology
- Prediabetic State - diagnosis Prediabetic State - epidemiology Prediabetic State - etiology
- Prevalence -
- Risk Factors -
- Young Adult -
- Find related publications in this database (Keywords)
- polycystic ovary syndrome
- oral glucose tolerance test
- prediabetes
- type 2 diabetes
- HbA1c