Browse > Article
http://dx.doi.org/10.5653/cerm.2020.04308

Predictive capability of fasting-state glucose and insulin measurements for abnormal glucose tolerance in women with polycystic ovary syndrome  

Chun, Sungwook (Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine)
Publication Information
Clinical and Experimental Reproductive Medicine / v.48, no.2, 2021 , pp. 156-162 More about this Journal
Abstract
Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the "less accurate" category for prediction. Conclusion: Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.
Keywords
Fasting; Glucose; Glucose tolerance test; Insulin; Polycystic ovary syndrome;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Peterson KR, Link M, Peterson CM. Endocrine disorder. In: Berek JS, editor. Berek & Novak's gynecology. 16th ed. Philadelphia: Lippincott Williams & Wilkins; 2019. p. 889-941.
2 Ketema EB, Kibret KT. Correlation of fasting and postprandial plasma glucose with HbA1c in assessing glycemic control; systematic review and meta-analysis. Arch Public Health 2015;73:43.   DOI
3 Saxena P, Prakash A, Nigam A. Efficacy of 2-hour post glucose insulin levels in predicting insulin resistance in polycystic ovarian syndrome with infertility. J Hum Reprod Sci 2011;4:20-2.   DOI
4 Qiao Q, Jousilahti P, Eriksson J, Tuomilehto J. Predictive properties of impaired glucose tolerance for cardiovascular risk are not explained by the development of overt diabetes during follow-up. Diabetes Care 2003;26:2910-4.   DOI
5 McCartney CR, Marshall JC. Clinical practice: polycystic ovary syndrome. N Engl J Med 2016;375:54-64.   DOI
6 Sam S, Dunaif A. Polycystic ovary syndrome: syndrome XX? Trends Endocrinol Metab 2003;14:365-70.   DOI
7 Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod 2018;33:1602-18.   DOI
8 Chun S. 1-h Postprandial glucose level is related to the serum anti-Mullerian hormone level in women with polycystic ovary syndrome. Gynecol Endocrinol 2015;31:815-8.   DOI
9 Bartnik M, Malmberg K, Hamsten A, Efendic S, Norhammar A, Silveira A, et al. Abnormal glucose tolerance: a common risk factor in patients with acute myocardial infarction in comparison with population-based controls. J Intern Med 2004;256:288-97.   DOI
10 Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000;45:23-41.   DOI
11 Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006;29:1130-9.   DOI
12 Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York: John Wiley & Sons; 2000.
13 Swets JA. Measuring the accuracy of diagnostic systems. Science 1988;240:1285-93.   DOI
14 Powers AC, Niswender KD, Evans-Molina C. Chapter 396: diabetes mellitus: diagnosis, classification, and pathophysiology [Internet]. New York: McGraw-Hill; 2021 [cited 2021 May 1]. Available from: http://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192288322.
15 Lobo JM, Jimenez-Valverde A, Real R. AUC: a misleading measure of the performance of predictive distribution models. Glob Ecol Biogeogr 2008;17:145-51.   DOI
16 Hall JE. Insulin, glucagon, and diabetes mellitus. In: Hall JE, editor. Guyton and Hall textbook of medical physiology. 13th ed. Philadelphia: Elsevier; 2016. p.983-99.
17 Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R, et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007;30:753-9.   DOI
18 American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care 2018;41(Suppl 1):S13-27.   DOI
19 Kim JJ, Hwang KR, Oh SH, Chae SJ, Yoon SH, Choi YM. Prevalence of insulin resistance in Korean women with polycystic ovary syndrome according to various homeostasis model assessment for insulin resistance cutoff values. Fertil Steril 2019;112:959-66.e1.   DOI
20 Chen X, Yang D, Li L, Feng S, Wang L. Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome. Hum Reprod 2006;21:2027-32.   DOI
21 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome. Fertil Steril 2004;81:19-25.
22 Taylor HS, Pal L, Sell E. Clinical gynecologic endocrinology and infertility. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2019.
23 Ehrmann DA. Polycystic ovary syndrome. N Engl J Med 2005;352:1223-36.   DOI
24 World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1: diagnosis and classification of diabetes mellitus [Internet]. Geneva: World Health Organization; 1999 [cited 2021 May 1]. Available from: https://apps.who.int/iris/handle/10665/66040.
25 Carmina E, Lobo RA. Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Fertil Steril 2004;82:661-5.   DOI
26 Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565-92.   DOI
27 Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS consensus workshop group. Fertil Steril 2012;97:28-38.e25.   DOI
28 Shaw JE, Zimmet PZ, de Courten M, Dowse GK, Chitson P, Gareeboo H, et al. Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care 1999;22:399-402.   DOI
29 Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003;9:505-14.   DOI
30 Park CH, Chun S. Association between serum gonadotropin level and insulin resistance-related parameters in Korean women with polycystic ovary syndrome. Obstet Gynecol Sci 2016;59:498-505.   DOI