Abstract
Study Objective
The aim of this study was to examine the prevalence of and risk factors for abnormal
glucose metabolism in a large population of adolescents with polycystic ovary syndrome
(PCOS).
Design, Setting, Participants, Interventions, and Main Outcome Measures
A retrospective chart review was performed of 360 patients who presented to the pediatric
gynecology outpatient clinic for evaluation of PCOS between January 2004 and May 2012.
Results
A total of 163 patients fulfilled criteria for a diagnosis of PCOS and had adequate
clinical and laboratory data. Twenty-six adolescents (16.0%) had impaired glucose
tolerance and 2 patients (1.2%) met criteria for a provisional diagnosis of type 2
diabetes. All 28 subjects with abnormal glucose metabolism were identified using the
2-hour plasma glucose of the oral glucose tolerance test. Conversely, the fasting
glucose values only successfully detected 2 patients with hyperglycemia, both of whom
also had abnormal 2-hour glucose levels. Adolescents with abnormal glucose metabolism
were more likely to have reported a positive family history (P = .02) and had higher body mass index z scores (2.8 ± 1.1 vs 1.8 ± 1.2; P < .01). When patients were classified into normal weight (n = 29) and obese/overweight
groups (n = 117), all of the patients with abnormal glucose metabolism were overweight
or obese.
Conclusion
In the largest series to date, we describe a prevalence of abnormal glucose metabolism
in adolescent patients with PCOS of 17.2%. Abnormal glucose metabolism is associated
with many of the known risk factors for metabolic syndrome. Our results support that
the oral glucose tolerance test is a superior diagnostic test to assess abnormal glucose
levels in overweight and obese adolescents but that this test might have limited utility
in normal weight adolescents with PCOS.
Key Words
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Article info
Publication history
Published online: June 10, 2015
Footnotes
Jill Hamilton is supported by the Mead Johnson Chair in Nutritional Science. The other authors have no relevant conflicts to disclose.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
