Screening for Abnormal Glucose Tolerance in Adolescents with Polycystic Ovary Syndrome

Palmert, Mark R.; Gordon, Catherine M.; Kartashov, Alex I.; Legro, Richard S.; Emans, S. Jean; Dunaif, Andrea

doi:10.1210/jcem.87.3.8305

Cited by 354Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Screening for Abnormal Glucose Tolerance in Adolescents with Polycystic Ovary Syndrome

Palmert, Mark R., Gordon, Catherine M., Kartashov, Alex I., Legro, Richard S., Emans, S. Jean, Dunaif, Andrea·2002·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jcem.87.3.8305

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Abstract

Insulin resistance is common in adults with polycystic ovary syndrome (PCOS). Although recent data demonstrate that insulin resistance is present in the early stages of PCOS, the prevalence of insulin resistance in adolescents with PCOS has not been determined. Likewise, the prevalence of impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM) in adolescent cohorts has not been established. In this study we sought to obtain preliminary data regarding the prevalence of IGT and DM in adolescents with PCOS and to assess the ability of screening tests to predict these abnormalities within this population. Twenty-seven adolescents with PCOS underwent oral glucose tolerance tests. Plasma glucose and insulin levels were obtained at baseline, and glucose was measured 2 h after a 75-g glucose challenge. The 2-h plasma glucose level was used to categorize subjects as having IGT or the provisional diagnosis of DM. Eight of our 27 subjects had IGT, and 1 had previously undiagnosed DM. These abnormalities were seen among lean and obese subjects. Fasting plasma glucose levels and simple measures of insulin resistance were suboptimal predictors of IGT and DM within our cohort. As in adults, our results indicate that adolescents with PCOS are at increased risk for IGT and DM and that the 2-h plasma glucose level after an oral glucose challenge appears to be the most reliable screening test for these abnormalities. Our results need to be corroborated by future studies that determine the prevalence of abnormalities in glucose tolerance among large populations of adolescents, both with and without PCOS. However, as DM may be preventable by lifestyle modifications, we would recommend that adolescents with PCOS undergo periodic screening for abnormal glucose tolerance using 2-h postchallenge plasma glucose levels.

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Insulin resistance at least in part contributes to impaired glucose tolerance and increased risk of developing type 2 diabetes mellitus.
“Insulin resistance at least in part contributes to IGT and increased risk of developing type 2 diabetes mellitus [5–7].”
From Dysglycemia screening with oral glucose tolerance test in adolescents with polycystic ovary syndrome and relationship with obesity (2022) · cites this paper as [7]
The prevalence of impaired glucose tolerance in women with PCOS is almost 30% in both adult women and affected adolescents.
“In women with PCOS, dysglycemia typically consists of impaired glucose tolerance [12], its prevalence being of almost 30% in both adult women [13] and affected adolescents [14].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [14]
Additional comorbidities can occur in adolescents with PCOS that might be independent of overweight status.
“Additional comorbidities can occur in adolescents with PCOS that might be independent of overweight status.”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [210]
These comorbidities include impaired glucose tolerance and type 2 diabetes.
“These comorbidities include impaired glucose tolerance and type 2 diabetes [125, 126, 210, 211].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [210]

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“In addition to insulin resistance and compensatory hyperinsulinemia that appear to play a role in the pathophysiology of elevated androgens (3,4), adolescents with PCOS also may have glucose intolerance (5), metabolic syndrome (6) and dyslipidemia (3), increasing risk for type 2 diabetes and cardiovascular disease lat…”
Self-citation

Study on abnormal glucose tolerance in adolescents with polycystic ovary syndrome
Mei-zh, L. (2005) · Chinese Journal of Reproductive Health
Abnormal Glucose Tolerance in Adolescents with Polycystic Ovary Syndrome
Li-ming, Y. (2006)
Screening for Abnormal Glucose Metabolism in Adolescents with Polycystic Ovary Syndrome (PCOS)
Bekx, M. T., Nir, J., & Connor, E. L. (2012) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2011.12.020
Polycystic ovary syndrome in adolescence: impaired glucose tolerance occurs across the spectrum of BMI: IGT in adolescent polycystic ovary syndrome
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Dysglycemia Among Adolescents With Polycystic Ovarian Syndrome
Bremer, K., Coles, N., Kives, S. L., & Hamilton, J. K. (2014) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2014.01.012

Authors: Palmert, M. R., Gordon, C. M., Kartashov, A. I., Legro, R. S., Emans, S. J., & Dunaif, A.
Affiliations: Boston Children's Hospital (US)
Harvard University (US)
Pennsylvania State University (US)
Brigham and Women's Hospital (US)
ORCID: Palmert, Mark R.
Gordon, Catherine M.
Legro, Richard S.
Emans, S. Jean
Dunaif, Andrea
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2002-03
Volume: 87
Issue: 3
Pages: 1017-1023
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jcem.87.3.8305
OpenAlex: W2141862257
Cited by: 354
References: 41
Citations by year: 2026: 3 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 10 · 2020: 6 · 2019: 12 · 2018: 8 · 2017: 7 · 2016: 14 · 2015: 21 · 2014: 19 · 2013: 20 · 2012: 34
FWCI: 20.68
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention
U.S. Public Health Service (T71-MC00009-09-S1-RO)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK040605)
National Center for Research Resources (M01RR010732, M01RR002172, K23RR015544, M01-RR-0265)
NIH Clinical Center
Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD034449, K24HD001476)
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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: polycystic ovary syndrome, adolescents, impaired glucose tolerance, type 2 diabetes, insulin resistance, oral glucose tolerance test, fasting blood glucose
MeSH terms: Adolescent, Diabetes Mellitus, Type 1, Female, Glucose Tolerance Test, Humans, Mass Screening, Polycystic Ovary Syndrome, Prevalence, Glucose Intolerance

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Screening for Abnormal Glucose Tolerance in Adolescents with Polycystic Ovary Syndrome

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