Cited by 1,257Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGestational Diabetes Research and Management

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Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.

Ehrmann, D A, Barnes, R B, Rosenfield, R L, Cavaghan, M K, Imperial, J·1999·Diabetes Care

DOI 10.2337/diacare.22.1.141

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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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Background
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“dyslipidemia [3], and markedly increased risk of type 2 diabetes [4].”
Background
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Background
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“According to some studies PCOS patients have an adverse cardiovascular risk profile – increased risk for diabetes mellitus [3,4], arterial hypertension [5], dislipidemia [6–8] and subclinical inflammation and atherosclerosis [9–11].”
Retinal Nerve Fiber Layer Thickness in Women with Polycystic Ovary Syndrome
Demir, M., Güven, D., Koc, A., Özdemir, S., & Can, E. (2013) · Journal of Ophthalmology · doi:10.1155/2013/752186 · Cited by 18
“More than 40% of women with PCOS might develop impaired glucose tolerance or type 2 diabetes mellitus [5, 6].”
Background
A Putative Relationship between Valproic Acid and Polycystic Ovarian Syndrome: Implications for Treatment of Women with Seizure and Bipolar Disorders
Joffe, H., Hall, J. E., Cohen, L. S., Taylor, A. E., & Baldessarini, R. J. (2003) · Harvard Review of Psychiatry · doi:10.1080/10673220303957 · Cited by 18
Metformin in the Treatment of Polycystic Ovary Syndrome
Ab, M. (2008) · Current Pharmaceutical Design · doi:10.2174/138161208785294609 · Cited by 18
Thiazolidinediones for the Therapeutic Management of Polycystic Ovary Syndrome
Elkind-Hirsch, K. E. (2006) · Treatments in Endocrinology · doi:10.2165/00024677-200605030-00005 · Cited by 18
Efficacy of Myo-inositol on anthropometric, metabolic, and endocrine outcomes in PCOS patients: a meta-analysis of randomized controlled trial
Jethaliya, H., Gajjar, N., Patel, V., Deshpande, S., & Patel, R. (2022) · Reproductive Sciences · doi:10.1007/s43032-022-00933-y · Cited by 17
“Along with this, long-term health consequences of PCOS are type 2 diabetes mellitus [2, 3], dyslipidemia [4], low-grade inflammation [5], endothelial dysfunction [6], and psychological distress [7, 8].”
Diagnosing Dysglycemia in Adolescents With Polycystic Ovary Syndrome
Gooding, H. C., Milliren, C., St. Paul, M., Mansfield, M. J., & DiVasta, A. (2014) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.12.020 · Cited by 17
From Pathophysiology to Treatment: The Role of Ferroptosis in PCOS
An, J., Zhou, Q., Guo, X., Xu, C., Jia, X., Cao, Z., & Lu, Q. (2025) · Frontiers in Bioscience-Landmark · doi:10.31083/fbl25586 · Cited by 18
Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals
Becerra-Fernández, A., López, G. P., Román, M. M., Martin-Lazaro, J. F., Pérez, M. J. L., Araque, N. A., Rodríguez-Molina, J. M., Sertucha, M. C. B., & Vilas, M. V. A. (2014) · Endocrinología y Nutrición (English Edition) · doi:10.1016/j.endoen.2014.06.012 · Cited by 17
Chronic anovulation and the polycystic ovary syndrome
KASE, N. G. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139003254.012 · Cited by 16
Proliferation of Ovarian Granulosa Cells in Polycystic Ovarian Syndrome Is Regulated by MicroRNA-24 by Targeting Wingless-Type Family Member 2B (WNT2B)
Yuanyuan, Z., Zeqin, W., Xiaojie, S., Liping, L., Yun, X., & Jieqiong, Z. (2019) · Medical Science Monitor · doi:10.12659/msm.915320 · Cited by 17
“Further, studies have shown that although women with mild PCOS tend to have normal ovulation, the disorder becomes chronic if untreated [5].”
Background
Association of oral contraceptive and metformin did not improve insulin resistance in women with polycystic ovary syndrome
Iwata, M. C., Porquere, L., Sorpreso, I. C. E., Baracat, E. C., & Soares, J. M. (2015) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.61.03.215 · Cited by 19
The quantitative insulin sensitivity check index is not able to detect early metabolic alterations in young patients with polycystic ovarian syndrome
Angioni, S. L., Sanna, S., Magnini, R., Melis, G. B., & Fulghesu, A. M. (2010) · Gynecological Endocrinology · doi:10.3109/09513590.2010.492886 · Cited by 17
“Indeed, patients with PCOS present an increased risk for hypertension, coronary heart disease and diabetes mellitus type 2 (DMT2) [2].”
Background
Phytotherapy for Polycystic Ovarian Syndrome: A review of the literature and evaluation of practitioners’ experiences
Rooney, S., & Pendry, B. A. (2014) · Journal of Herbal Medicine · doi:10.1016/j.hermed.2014.05.001 · Cited by 19
Vitamin D Deficiency among Adolescent Females with Polycystic Ovary Syndrome
Sadhir, M., Kansra, A. R., & Menon, S. (2014) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2014.11.004 · Cited by 17
Metabolic disorders in patients with recent gestational diabetes mellitus
Eroglu, D. U., & Zeyneloğlu, H. B. (2006) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2006.00418.x · Cited by 17
Correlation between glucose metabolism and serum steroid hormones in patients with polycystic ovary syndrome
Li, X., Zhang, T., Li, S., Deng, Y., Wang, L., Tao, T., Wang, S., Gu, Y., Gu, W., Hong, J., et al. (2020) · Clinical Endocrinology · doi:10.1111/cen.14154 · Cited by 17
Association of Age and Sex With Cardiovascular Risk Factors and Insulin Sensitivity in Overweight Children and Adolescents
Koenigsberg, J., Boyd-Woschinko, G. S., Gidding, S. S., Hassink, S. G., & Falkner, B. E. (2006) · Journal of the CardioMetabolic Syndrome · doi:10.1111/j.1559-4564.2006.05695.x · Cited by 17
Hyperandrogenism, Hirsutism, and Polycystic Ovary Syndrome
Rosenfield, R. L., Barnes, R. B., & Ehrmann, D. A. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-18907-1.00133-5 · Cited by 17
Self-citation
Utility of the Oral Glucose Tolerance Test to Assess Glucose Abnormalities in Adolescents with Polycystic Ovary Syndrome
Coles, N., Bremer, K., Kives, S., Zhao, X., & Hamilton, J. (2016) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2015.06.004 · Cited by 16
Pancreatic β-cell dysfunction in polycystic ovary syndrome: the role of metformin
Messer, C., Boston, R., Leroith, D., Geer, E., Miller, J. D., Messer, M., & Futterweit, W. (2012) · Endocrine Practice · doi:10.4158/ep11375.or · Cited by 16
“The prevalence of both impaired glucose tolerance (IGT) and type 2 diabetes mellitus in patients with PCOS significantly exceeds normal population estimates (8,9).”
Background
The Role of Diet, Glycaemic Index and Glucose Control in Polycystic Ovary Syndrome (PCOS) Management and Mechanisms of Progression
Johnson, C., Garipoğlu, G., Jeanes, Y., Frontino, G., & Costabile, A. (2025) · Current Nutrition Reports · doi:10.1007/s13668-024-00601-4 · Cited by 23
Ethinyl estradiol–drospirenone vs ethinyl estradiol–drospirenone plus metformin in the treatment of lean women with polycystic ovary syndrome
Çınar, N., Harmancı, A., Bayraktar, M., & Yıldız, B. O. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2012.04415.x · Cited by 16
Clinical features, investigations and management of adolescents with polycystic ovary syndrome
Orsino, A., Eyk, N. V., & Hamilton, J. K. (2005) · Paediatrics & Child Health · doi:10.1093/pch/10.10.602 · Cited by 16
Altered glucose disposition and insulin sensitivity in peri-pubertal first-degree relatives of women with polycystic ovary syndrome
Raissouni, N., Kolesnikov, A., Purushothaman, R., SINHA, S. K., Bhandari, S., Bhangoo, A., Malik, S., Mathew, R. P., Baillargeon, J., Hernández, M. I., et al. (2012) · International Journal of Pediatric Endocrinology · doi:10.1186/1687-9856-2012-14 · Cited by 16
“Insulin resistance in PCOS women has long-term health consequences, predisposing to type 2 diabetes mellitus, cardiovascular disease and pregnancy-associated disorders like infertility, miscarriage, premature labor and gestational diabetes [11-15].”
Background
PREVALENCE AND PREDICTORS OF METABOLIC SYNDROME IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME- A STUDY FROM SOUTHERN INDIA
Varghese, J., Kantharaju, S., Thunga, S., Joseph, N., & SINGH, P. (2015) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.5455/2320-1770.ijrcog20150222 · Cited by 16
Insulin Resistance: Causes and Consequences
Bloomgarden, Z. T. (2005) · International review of neurobiology · doi:10.1016/s0074-7742(04)65001-x · Cited by 16
Absence of Polycystic Ovary Syndrome Features in Human Immunodeficiency Virus-Infected Women Despite Significant Hyperinsulinemia and Truncal Adiposity
Johnsen, S., Dolan, S. E., Fitch, K. V., Killilea, K. M., Shifren, J. L., & Grinspoon, S. K. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-1083 · Cited by 16
Polycystic ovary syndrome
Pfeifer, S. M. (2003) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/s1083-3188(03)00131-1 · Cited by 16
Statins for women with polycystic ovary syndrome not actively trying to conceive
Raval, A. D., Hunter, T., Stuckey, B. G. A., & Hart, R. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008565 · Cited by 16
Genomic analyses implicate hormonal and metabolic dysregulation in polycystic ovary syndrome
Moolhuijsen, L. M. E., Zhu, J., Mullin, B. H., Pujol‐Gualdo, N., Actkins, K. V., Mack, J. A., Rao, H., Trivedi, B., Kentistou, K. A., Zhao, Y., et al. (2026) · Nature Genetics · doi:10.1038/s41588-026-02543-9 · Cited by 30
“Our findings highlight important links between PCOS and T2D and CAD, through mechanisms that are related to and also independent of adiposity.”
Self-citation
Recent advances in the treatment of polycystic ovary syndrome
Yıldız, B. O. (2004) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.13.10.1295 · Cited by 16
“Women with PCOS are at substantially higher risk for impaired glucose tolerance (IGT) and Type 2 diabetes, with combined prevalence rates of 35 – 40% for glucose intolerance [92-94].”
Background
Adiponectin levels reflect the different phenotypes of polycystic ovary syndrome: study in normal weight, normoinsulinemic patients
Karkanaki, A., Piouka, A., Katsikis, I., Farmakiotis, D., Μacut, D., & Panidis, D. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.06.034 · Cited by 15
The prevalence of glucose metabolism abnormalities in Greek women with polycystic ovary syndrome
Trakakis, E., Basios, G., Peppa, Μ., Simeonidis, G., Labos, G., Creatsa, M. G., Misailidou, M., Boutati, E. I., Vaggopoulos, V., Παναγόπουλος, Π., et al. (2012) · Gynecological Endocrinology · doi:10.3109/09513590.2012.683058 · Cited by 15
Midlife women’s health consequences associated with polycystic ovary syndrome
Ali, A. T., & Guidozzi, F. (2019) · Climacteric · doi:10.1080/13697137.2019.1679111 · Cited by 16
Comparison of metabolic syndrome elements in White and Asian women with polycystic ovary syndrome: results of a regional, American cross-sectional study
Chahal, N., Quinn, M. M., Greenwood, E. A., Kao, C., Cedars, M. I., & Huddleston, H. G. (2020) · F&S Reports · doi:10.1016/j.xfre.2020.09.008 · Cited by 15

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
DOI: 10.2337/diacare.22.1.141
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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Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.

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