Abstract
Objective: To compare screening strategies for type 2 diabetes mellitus (DM), impaired glucose tolerance (pre-DM), and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Academic reproductive endocrinology practice. Patient(s): Adult women with PCOS (n = 111). Intervention(s): None. Main Outcome Measure(s): Subjects were screened for pre-DM and DM using a 2-hour glucose tolerance test (GTT), hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG) and for IR using homeostasis model assessment (HOMA), insulin levels (fasting and 2 hours after 75 glucose load), or obesity. Screening approaches were compared using positive and negative percent agreement and Cohen's kappa (κ). Result(s): DM and pre-DM were diagnosed by GTT in 4% and 20% of subjects, respectively. Screening with FPG failed to identify 41% of pre-DM and 20% of DM subjects. GTT and HbA1c had only fair agreement (κ = 0.29). IR was diagnosed in 24% of subjects with pre-DM or DM and in 56% of the remaining subjects using HOMA and insulin levels. HOMA and elevated insulin levels demonstrated substantial agreement for detecting IR (κ = 0.70-0.73). Obesity demonstrated fair to slight agreement (κ = 0.33-0.18). Conclusion(s): Women with PCOS should be screened for Pre-DM and DM using GTT or HbA1c, and those with Pre-DM or DM are presumed to have IR. In the rest, IR can be detected using either HOMA or insulin levels.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1043-1047 |
| Number of pages | 5 |
| Journal | Fertility and Sterility |
| Volume | 96 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 1 2011 |
| Externally published | Yes |
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Keywords
- blood glucose
- hemoglobin A1c
- insulin resistance
- oral glucose tolerance test
- Polycystic ovarian syndrome
- type 2 diabetes mellitus
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Reproductive Medicine
Cite this
Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome. / Hurd, William W.; Abdel-Rahman, Mohamed Y.; Ismail, Salah A.; Abdellah, Mostafa A.; Schmotzer, Christine L.; Sood, Ajay.
In: Fertility and Sterility, Vol. 96, No. 4, 01.10.2011, p. 1043-1047.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome
AU - Hurd, William W.
AU - Abdel-Rahman, Mohamed Y.
AU - Ismail, Salah A.
AU - Abdellah, Mostafa A.
AU - Schmotzer, Christine L.
AU - Sood, Ajay
PY - 2011/10/1
Y1 - 2011/10/1
N2 - Objective: To compare screening strategies for type 2 diabetes mellitus (DM), impaired glucose tolerance (pre-DM), and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Academic reproductive endocrinology practice. Patient(s): Adult women with PCOS (n = 111). Intervention(s): None. Main Outcome Measure(s): Subjects were screened for pre-DM and DM using a 2-hour glucose tolerance test (GTT), hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG) and for IR using homeostasis model assessment (HOMA), insulin levels (fasting and 2 hours after 75 glucose load), or obesity. Screening approaches were compared using positive and negative percent agreement and Cohen's kappa (κ). Result(s): DM and pre-DM were diagnosed by GTT in 4% and 20% of subjects, respectively. Screening with FPG failed to identify 41% of pre-DM and 20% of DM subjects. GTT and HbA1c had only fair agreement (κ = 0.29). IR was diagnosed in 24% of subjects with pre-DM or DM and in 56% of the remaining subjects using HOMA and insulin levels. HOMA and elevated insulin levels demonstrated substantial agreement for detecting IR (κ = 0.70-0.73). Obesity demonstrated fair to slight agreement (κ = 0.33-0.18). Conclusion(s): Women with PCOS should be screened for Pre-DM and DM using GTT or HbA1c, and those with Pre-DM or DM are presumed to have IR. In the rest, IR can be detected using either HOMA or insulin levels.
AB - Objective: To compare screening strategies for type 2 diabetes mellitus (DM), impaired glucose tolerance (pre-DM), and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Academic reproductive endocrinology practice. Patient(s): Adult women with PCOS (n = 111). Intervention(s): None. Main Outcome Measure(s): Subjects were screened for pre-DM and DM using a 2-hour glucose tolerance test (GTT), hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG) and for IR using homeostasis model assessment (HOMA), insulin levels (fasting and 2 hours after 75 glucose load), or obesity. Screening approaches were compared using positive and negative percent agreement and Cohen's kappa (κ). Result(s): DM and pre-DM were diagnosed by GTT in 4% and 20% of subjects, respectively. Screening with FPG failed to identify 41% of pre-DM and 20% of DM subjects. GTT and HbA1c had only fair agreement (κ = 0.29). IR was diagnosed in 24% of subjects with pre-DM or DM and in 56% of the remaining subjects using HOMA and insulin levels. HOMA and elevated insulin levels demonstrated substantial agreement for detecting IR (κ = 0.70-0.73). Obesity demonstrated fair to slight agreement (κ = 0.33-0.18). Conclusion(s): Women with PCOS should be screened for Pre-DM and DM using GTT or HbA1c, and those with Pre-DM or DM are presumed to have IR. In the rest, IR can be detected using either HOMA or insulin levels.
KW - blood glucose
KW - hemoglobin A1c
KW - insulin resistance
KW - oral glucose tolerance test
KW - Polycystic ovarian syndrome
KW - type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=80053305605&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053305605&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2011.07.002
DO - 10.1016/j.fertnstert.2011.07.002
M3 - Article
C2 - 21813121
AN - SCOPUS:80053305605
VL - 96
SP - 1043
EP - 1047
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 4
ER -