Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome
Open accessAbstract
Objective To compare screening strategies for type 2 diabetes mellitus (DM), impaired glucose tolerance (pre-DM), and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS).Design Prospective study.Setting Academic reproductive endocrinology practice.Patient(s) Adult women with PCOS (n = 111).Intervention(s) None.Main outcome measure(s) Subjects were screened for pre-DM and DM using a 2-hour glucose tolerance test (GTT), hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG) and for IR using homeostasis model assessment (HOMA), insulin levels (fasting and 2 hours after 75 glucose load), or obesity. Screening approaches were compared using positive and negative percent agreement and Cohen's kappa (κ).Result(s) DM and pre-DM were diagnosed by GTT in 4% and 20% of subjects, respectively. Screening with FPG failed to identify 41% of pre-DM and 20% of DM subjects. GTT and HbA1c had only fair agreement (κ = 0.29). IR was diagnosed in 24% of subjects with pre-DM or DM and in 56% of the remaining subjects using HOMA and insulin levels. HOMA and elevated insulin levels demonstrated substantial agreement for detecting IR (κ = 0.70-0.73). Obesity demonstrated fair to slight agreement (κ = 0.33-0.18).Conclusion(s) Women with PCOS should be screened for Pre-DM and DM using GTT or HbA1c, and those with Pre-DM or DM are presumed to have IR. In the rest, IR can be detected using either HOMA or insulin levels.
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Reported prevalence of insulin resistance in women with PCOS varies from 44% to 70%, mostly because of different methods used to assess it.
“Reported prevalence of IR in women with PCOS varies from 44% to 70% [19] mostly because of different methods used to assess it [20].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [20]
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- Authors
- Hurd, W. W., Abdel-Rahman, M. Y., Ismail, S. A., Abdellah, M. A., Schmotzer, C. L., & Sood, A.
- Affiliations
- University Hospitals Cleveland Medical Center (US)
- Sohag University (EG)
- Corresponding author
- Hurd, William W.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 96
- Issue
- 4
- Pages
- 1043-1047
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2139408020
- Cited by
- 46
- References
- 34
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 6 · 2015: 9 · 2014: 4 · 2013: 4 · 2012: 6
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- polycystic ovary syndrome, type 2 diabetes, insulin resistance, impaired glucose tolerance, diabetes screening, glucose tolerance test, HbA1c, fasting blood glucose, HOMA, insulin levels, obesity, screening agreement
- MeSH terms
- Adolescent, Adult, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Insulin Resistance, Mass Screening, Middle Aged, Polycystic Ovary Syndrome, Prospective Studies, Cohort Studies, Biomarkers, Young Adult
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