Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.
Abstract
OBJECTIVE: NIDDM occurs commonly among women with polycystic ovary syndrome (PCOS). The prevalence and natural history of its precursor, impaired glucose tolerance (IGT), is less well known. The objective of this study was to characterize the prevalence and incidence of glucose intolerance in a large cohort of women with well-characterized PCOS. RESEARCH DESIGN AND METHODS: A total of 122 women with clinical and hormonal evidence of PCOS were recruited from the Medicine, Endocrinology, Gynecology, and Pediatrics Clinics at the University of Chicago. All women had a standard oral glucose tolerance test (OGTT) with measurement of glucose and insulin levels. A subset of 25 women were subsequently restudied with the aim of characterizing the natural history of glucose tolerance in PCOS. RESULTS: Glucose tolerance was abnormal in 55 (45%) of the 122 women: 43 (35%) had IGT and 12 (10%) had NIDDM at the time of initial study. The women with NIDDM differed from those with normal glucose tolerance in that they had a 2.6-fold higher prevalence of first-degree relatives with NIDDM (83 vs. 31%, P < 0.01 by chi 2) and were significantly more obese (BMI 41.0 +/- 2.4 vs. 33.4 +/- 1.1 kg/m2, P < 0.01). For the entire cohort of 122 women, there was a significant correlation between fasting and 2-h glucose concentrations (r = 0.76, P < 0.0001); among the subset with IGT, the fasting glucose concentration was poorly predictive of the 2-h level (r = 0.25, NS). After a mean follow-up of 2.4 +/- 0.3 years (range 0.5-6.3), 25 women had a second OGTT. The glucose concentration at 2 h during the second glucose tolerance test was significantly higher than the 2-h concentration during the first study (161 +/- 9 vs. 139 +/- 6 mg/dl, P < 0.02). CONCLUSIONS: The prevalence of IGT and NIDDM in women with PCOS is substantially higher than expected when compared with age- and weight-matched populations of women without PCOS. The conversion from IGT to NIDDM is accelerated in PCOS. The fasting glucose concentration does not reliably predict the glucose concentration at 2 h after an oral glucose challenge, particularly among those with IGT, the subgroup at highest risk for subsequent development of NIDDM. We conclude that women with PCOS should periodically have an OGTT and must be closely monitored for deterioration in glucose tolerance.
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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 [13]
Earlier-onset hyperglycaemia and rapid progression to DM2 is also reported in PCOS.
“Earlier-onset hyperglycaemia and rapid progression to DM2 is also reported in PCOS. 104,105”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [104]
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BackgroundObesity and Polycystic Ovary Syndrome
Vrbíková, J., & Hainer, V. (2009) · Obesity Facts · doi:10.1159/000194971 · Cited by 237 · see citing works
Filho, F. L. T., Baracat, E. C., Lee, T. H., Suh, C. S., Matsui, M., Chang, R. J., Shimasaki, S., & Erickson, G. F. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8316 · Cited by 237 · see citing works
INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES
Baru, P. C. R. (2014) · ADVANCED SCIENCES INDEX · Cited by 236 · see citing works
ACOG Practice Bulletin No. 194: polycystic ovary syndrome
(2018) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002656 · Cited by 231 · see citing works
The role of lifestyle modification in polycystic ovary syndrome
Norman, R. J., Davies, M. J., Lord, J., & Moran, L. J. (2002) · Trends in Endocrinology & Metabolism · doi:10.1016/s1043-2760(02)00612-4 · Cited by 326 · see citing works
Marsh, K. A., Steinbeck, K. S., Atkinson, F. S., Petocz, P., & Brand-Miller, J. C. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.29261 · Cited by 228 · see citing works
“Impaired glucose tolerance or overt type 2 diabetes develops by the age of 30 y in 30–50% of obese women with PCOS (4).”
BackgroundLong-term health consequences of PCOS
Wild, R. A. (2002) · Human Reproduction Update · doi:10.1093/humupd/8.3.231 · Cited by 232 · see citing works
Serum 25-hydroxyvitamin D concentrations in obese and non-obese women with polycystic ovary syndrome
Yıldızhan, R., Kurdoğlu, M., Adalı, E., Kolusarı, A., Yıldızhan, B., Şahin, H. G., & Kamacı, M. (2009) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-009-0958-7 · Cited by 231 · see citing works
“Women with PCOS are known to be at increased risk for the development of impaired glucose tolerance and type 2 diabetes mellitus (T2DM) [18].”
BackgroundIncreased Risk for Abnormal Depression Scores in Women With Polycystic Ovary Syndrome
Dokras, A., Clifton, S. C., Futterweit, W., & Wild, R. A. (2010) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e318202b0a4 · Cited by 229 · see citing works
Resistance to the Insulin and Elevated Level of Androgen: A Major Cause of Polycystic Ovary Syndrome
Ding, H., Zhang, J., Zhang, F., Zhang, S., Chen, X., Liang, W., & Xie, Q. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.741764 · Cited by 231 · see citing works
Diamanti‐Kandarakis, E., Spina, G., Kouli, C., & Migdalis, I. N. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.10.7904 · Cited by 229 · see citing works
“This syndrome in addition to chronic anovulation and hyperandrogenemia (3) is also characterized by several metabolic aberrations, including a high incidence of impaired glucose tolerance (4), hyperinsulinemia, and insulin resistance (5, 6), which, in turn, have shown to increase the risk of cardiovascular disease (7–…”
Morin-Papunen, L. C., Vauhkonen, I., Koivunen, R. M., Ruokonen, A., & Tapanainen, J. S. (2000) · Human Reproduction · doi:10.1093/humrep/15.6.1266 · Cited by 226 · see citing works
Polycystic Ovary Syndrome Is a Risk Factor for Type 2 Diabetes
Gambineri, A., Patton, L., Altieri, P., Pagotto, U., Pizzi, C., Manzoli, L., & Pasquali, R. (2012) · Diabetes · doi:10.2337/db11-1360 · Cited by 226 · see citing works
“Incidence data for type 2 diabetes in women with PCOS were derived from studies with several methodological limitations, including small sample size and, for most of them, a limited time of follow-up (13,18,19).”
MethodRisk of metabolic complications in the new PCOS phenotypes based on the Rotterdam criteria
Juran, R., Syrop, C. H., Davis, W. A., Voorhis, B. J. V., & Dokras, A. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.01.032 · Cited by 214 · see citing works
Farrell, K., & Antoni, M. H. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2010.03.081 · Cited by 209 · see citing works
Setji, T. L., Holland, N. D., Sanders, L. L., Pereira, K. C., Diehl, A. M., & Brown, A. J. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-2774 · Cited by 210 · see citing works
“(3), type 2 diabetes mellitus (4, 5), dyslipidemia (6), hyper-”
BackgroundPolycystic ovary syndrome in adolescents
Franks, S. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.61 · Cited by 210 · see citing works
Ehrmann, D. A., Kasza, K., Azziz, R., Legro, R. S., & Ghazzi, M. N. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0229 · Cited by 205 · see citing works
Self-citationGoodman‐Gruen, D., & Barrett-Connor, E. L. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.912 · Cited by 202 · see citing works
- Authors
- Ehrmann, D. A., Barnes, R. B., Rosenfield, R. L., Cavaghan, M. K., & Imperial, J.
- Affiliations
- University of Chicago (US)
- ORCID
- Rosenfield, R L
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1999-01-01
- Volume
- 22
- Issue
- 1
- Pages
- 141-146
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2007816906
- Cited by
- 1,257
- References
- 0
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 22 · 2023: 18 · 2022: 39 · 2021: 45 · 2020: 32 · 2019: 39 · 2018: 40 · 2017: 45 · 2016: 37 · 2015: 63 · 2014: 63 · 2013: 55 · 2012: 75
- FWCI
- 31.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k08dk002315-02)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-31842, DK 20595, DK-02315)
- 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, impaired glucose tolerance, type 2 diabetes, prevalence, incidence, natural history (disease), oral glucose tolerance test, fasting blood glucose, obesity, family history of diabetes, women's health
- MeSH terms
- Adult, Analysis of Variance, Blood Glucose, Chicago, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glucose Tolerance Test, Humans, Insulin, Polycystic Ovary Syndrome, Regression Analysis, Testosterone, Prevalence, Glucose Intolerance
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