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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Measures of Serum Markers HbA1c, HOMA-IR, HOMA-β, QUICKI and G/I Ratio as Predictors of Abnormal Glucose Tolerance Among Thai Women with Polycystic Ovary Syndrome
Wongwananuruk, T., Prasongvej, P., Chantrapanichkul, P., Indhavivadhana, S., Tanmahasamut, P., Rattanachaiyanont, M., Techatraisak, K., & Angsuwathana, S. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14051452 · Cited by 12
“A previous study reported that PCOS women with glucose intolerance exhibited higher BMI, waist circumference, blood pressure, triglyceride levels, free testosterone levels, fasting glucose levels, HbA1c and insulin levels [27].”
Vascular endothelial growth factor +405 G/C,−460 T/C and −2578 A/C polymorphisms are not associated with insulin resistance in polycystic ovary syndrome
Vural, P., Kiraz, Z. K., Doğru‐Abbasoğlu, S., Çil, E., Karadağ, B., & Uysal, M. (2010) · International Journal of Immunogenetics · doi:10.1111/j.1744-313x.2010.00915.x · Cited by 10
“…endocrinopathy, usually associated with insulin resistance (IR) and pancreatic b-cell dysfunction, with increased risk of type 2 diabetes mellitus (Ehrmann et al., 1999; * Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey and † Department of…”
Background
Role of Lifestyle and Diet in the Management of Polycystic Ovarian Syndrome
Krystock, A. (2013) · Springer eBooks · doi:10.1007/978-1-4614-8394-6_9 · Cited by 11
A correlative study of biochemical parameters in polycystic ovarian syndrome
Swetha, N. P., Vyshnavi, R., Modagan, P., & Rajagopalan, B. (2013) · Cited by 10
Is the Risk for Cardiovascular Disease Increased in all Phenotypes of the Polycystic Ovary Syndrome?
Daskalopoulos, G. N., Karkanaki, A., Karagiannis, A. I., Mikhailidis, D. P., & Athyros, V. G. (2011) · Angiology · doi:10.1177/0003319711399571 · Cited by 10
“In this setting, insulin output cannot overcome resistance, leading to hyperglycaemia.39 Women with PCOS are at increased risk of developing impaired glucose tolerance (IGT) and T2DM with prevalence rates of 31.3% and 7.5%, respectively, compared with 14% for IGT and 0% for T2DM in age-matched and weight-matched non-P…”
BackgroundInfluential
Le syndrome des ovaires polykystiques (SOPK)
Torre, A., & Fernandez, H. (2007) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/j.jgyn.2007.04.002 · Cited by 11
Relationship between Vitamin D and Insulin Resistance in Polycystic Ovary Syndrome Women
Singh, S., Agrawal, P. K., Garg, R., & Kokila, B. N. (2017) · Journal of South Asian Federation of Obstetrics and Gynaecology · doi:10.5005/jp-journals-10006-1497 · Cited by 10
The assessment of thyroid autoantibody levels in euthyroid polycystic ovary syndrome patients
Hepşen, S., Karaköse, M., Çakal, E., Öztekin, S., Ünsal, İ. Ö., Akhanlı, P., Uçan, B., & Özbek, M. (2018) · Journal of the Turkish-German Gynecological Association · doi:10.4274/jtgga.2018.0001 · Cited by 10
“Obesity, metabolic syndrome, dyslipidemia, insuline resistance, type 2 diabetes mellitus, and cardiovascular disorders are the most common comorbidities related to this syndrome (3,4,5,6).”
Background
Effects of Exercise Combined with Finasteride on Hormone and Ovarian Function in Polycystic Ovary Syndrome Rats
Wu, C., Jiang, F., Wei, K., Lin, F., & Jiang, Z. (2019) · International Journal of Endocrinology · doi:10.1155/2019/8405796 · Cited by 10
“In addition, a large number of population experiments have confirmed that sex hormone-binding protein was closely related to impaired glucose tolerance [31, 32].”
Background
Metabolic and Hormonal Profile of Adolescent Girls With Polycystic Ovary Syndrome With Concomitant Autoimmune Thyroiditis
Skrzyńska, K., Zachurzok, A., & Gawlik, A. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.708910 · Cited by 10
Ketogenic diet restores hormonal, apoptotic/proliferative balance and enhances the effect of metformin on a letrozole-induced polycystic ovary model in rats
Ahmed, A. F., Sharkawi, S. S., AbdelHameed, S. S., Bayoumi, A. M. A., Moussa, R. S., Alhakamy, N. A., Sadoun, H. A., Mansouri, R. A., El‐Moselhy, M. A., El‐Daly, M., et al. (2022) · Life Sciences · doi:10.1016/j.lfs.2022.121285 · Cited by 10
Age, body mass index, and serum level of DHEA-S can predict glucocorticoid receptor function in women with polycystic ovary syndrome
Μacut, D., Milutinović, D. V., Antić, I. B., Matić, G. M., Brkljačić, J. M., Panidis, D., Petakov, M. S., Spanos, N., Bjekić, J., Stanojlović, O. P., et al. (2009) · Endocrine · doi:10.1007/s12020-009-9277-9 · Cited by 10
HIGH SERUM FERRITIN CONCENTRATIONS IN POLYCYSTIC OVARY SYNDROME IS NOT RELATED TO INSULIN RESISTANCE
Sharifi, F., Mazloomi, S., & Mousavinasab, N. (2011) · Iranian journal of diabetes and obesity · Cited by 10
Effects of metformin on inappropriate LH release in women with polycystic ovarian syndrome and insulin resistance
Ulloa‐Aguirre, A., Portocarrero-Ortiz, L. A., Zariñán, T., Olivares, A., Carranza‐Lira, S., Veldhuis, J. D., & López-Alvarenga, J. C. (2006) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)61079-6 · Cited by 10
Insulin resistance: what is its role in the polycystic ovary syndrome?
Moghetti, P. (2002) · Current Opinion in Endocrinology & Diabetes · doi:10.1097/00060793-200212000-00002 · Cited by 10
Long-term health consequences of polycystic ovary syndrome
Κousta, E., & Franks, S. (2001) · Cambridge University Press eBooks · doi:10.1017/cbo9780511545191.007 · Cited by 11
Comment on “Prevalence and Predictors of Risk for Type 2 Diabetes Mellitus and Impaired Glucose Tolerance in Polycystic Ovary Syndrome”1
Ciampelli, M., Fulghesu, A. M., & Lanzone, A. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.8.5939-3 · Cited by 10
MicroRNA-21 modulates brown adipose tissue adipogenesis and thermogenesis in a mouse model of polycystic ovary syndrome
Rezq, S., Huffman, A. M., Basnet, J., Alsemeh, A. E., do Carmo, J. M., Cardozo, L. L. Y., & Romero, D. G. (2024) · Biology of Sex Differences · doi:10.1186/s13293-024-00630-2 · Cited by 11
“Obesity is the most common of these risk factors, with the major - ity of women with PCOS being obese or overweight [8, 9] and having increased central adiposity [10].”
Background
Early and long term coronary artery bypass grafting outcomes in patients under 45 years of age.
Zwoliński, R., Jander, S., Ostrowski, S., Bartczak, K., Kośmider, A., Banyś, A., & Jaszewski, R. (2013) · PubMed · Cited by 9
Investigation of Prevalence and Awareness of Polycystic Ovary Syndrome among Pakistani Females
Zulfiqar, S., Tahir, S., Gulraiz, S., Razzaq, M. A., Abid, A., Shahid, T., Babar, A., Rehman, B., Rafique, H., Noor, S., et al. (2022) · Proceedings of the Pakistan Academy of Sciences B Life and Environmental Sciences · doi:10.53560/ppasb(59-1)703 · Cited by 9
“However, obesity does aggravate many other aspects of the phenotype, especially cardiovascular risk factors such as glucose intolerance and dyslipidemia as compared to non-obese women [13-15].”
Background
Obesity in Polycystic Ovary Syndrome
Morán, C., Arriaga, M., Rodriguez, G., & Mor, S. (2012) · InTech eBooks · doi:10.5772/27774 · Cited by 9
“of carbohydrate intolerance and type 2 diabetes mellitus (Legro et al., 1999; Ehrmann et al., 1999).”
Background
SORCS1 polymorphism and insulin secretion in obese women with polycystic ovary syndrome
Hrovat, A., Kravos, N. A., Goričar, K., Jensterle, M., Janež, A., & Dolžan, V. (2016) · Gynecological Endocrinology · doi:10.3109/09513590.2015.1126818 · Cited by 9
Comparison of metabolic and endocrinal parameters in obese and nonobese women of polycystic ovarian syndrome with normal controls
Gupta, N., Radhakrishnan, G., Madhu, S., & Radhika, A. G. (2015) · Fertility Science and Research · doi:10.4103/2394-4285.180491 · Cited by 9
“found IGT in 35% of women with PCOS and diabetes in 10%.[30]”
Background
Virilizing doses of testosterone decrease circulating insulin levels and differentially regulate insulin signaling in liver and adipose tissue of females
Kothmann, K., Jacobsen, V., Laffitte, E., Bromfield, C. R., Grizzaffi, M., Jarboe, M., Braundmeier‐Fleming, A., Bahr, J. M., Nowak, R. A., & Newell‐Fugate, A. E. (2021) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00281.2020 · Cited by 10
Screening for dysglycaemia by oral glucose tolerance test should be recommended in all women with polycystic ovary syndrome
Li, R., Lam, K. S. L., Tam, S., Lee, V. C. Y., Yeung, T. W. Y., Cheung, P. T., Yeung, W. S. B., Ho, P. C., & Ng, E. H. Y. (2015) · Human Reproduction · doi:10.1093/humrep/dev166 · Cited by 9
“Meanwhile, another very recent report from a Czech group (n ¼ 330; Vrbikova et al., 2014) has also refuted the use of FG alone for this purpose, like most previously reported studies (Ehrmann et al., 1999; Legro et al., 1999; Barcellos et al., 2007; Gagnon and Baillargeon, 2007).”
ResultInfluential
Risk factors for the deterioration of glucose metabolism in polycystic ovary syndrome
Wang, J. X., & Norman, R. J. (2004) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)62130-x · Cited by 8
Effect of colchicine on polycystic ovary syndrome: an experimental study
Gözükara, İ., Pınar, N., Özcan, O., Özgür, T., Dokuyucu, R., Kurt, R. K., Kucur, S. K., & Aksoy, A. N. (2015) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-015-3933-5 · Cited by 9

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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