Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women.
Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women.
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DOI：
10.1210/jcem.84.1.5393
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
R. Legro;A. Kunselman;W. Dodson;A. Dunaif
中科院分区：
文献类型：
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作者：
R. Legro;A. Kunselman;W. Dodson;A. Dunaif
患有多囊卵巢综合征（PCOS）的女性具有胰岛素抵抗，具有胰岛素分泌缺陷，并且处于葡萄糖耐受不良的高风险中。我们进行这项研究，以确定PCOS妇女葡萄糖耐受不良的患病率和与此风险相关的参数。254例PCOS妇女，年龄14-44岁，在2个中心进行前瞻性评价，1个城市和种族多样性（n = 110）和1个农村和种族同质性（n = 144）。将农村PCOS妇女与80名体重、种族和年龄相似的对照妇女进行比较。在3天300 g碳水化合物饮食和过夜禁食后，给予75 g口服葡萄糖激发，0和2 h血样用于葡萄糖水平。根据WHO标准对糖尿病进行分类。糖耐量异常患病率为31.1%，糖尿病患病率为7.5%。在非肥胖的PCOS妇女（体重指数<27 kg/m2）中，IGT和糖尿病的发生率分别为10.3%和1.5%，糖耐量异常的发生率明显高于对照组（χ 2 = 7.0; P = 0.01;比值比= 2.76; 95%可信区间= 1.23-6.57）。与激发后血糖水平最相关的变量是空腹血糖水平（P < 0.0001）、PCOS状态（P = 0.002）、腰臀比（P = 0.01）和体重指数（P = 0.021）。与WHO标准相比，美国糖尿病协会标准应用于空腹血糖显著低估糖尿病（3.2% vs. 7.5%;卡方= 4.7; P = 0.046;比值比= 2.48; 95%置信区间= 1.01-6.69）。我们的结论是：1）PCOS妇女在所有体重和年轻时患IGT和2型糖尿病的风险显著增加; 2）这些患病率在2个不同的PCOS妇女人群中相似，表明PCOS可能是年轻妇女葡萄糖耐受不良的一个比种族或种族更重要的危险因素; 3）美国糖尿病协会糖尿病诊断标准未能通过激发后血糖值检测出大量患有糖尿病的PCOS女性。
Women with polycystic ovary syndrome (PCOS) are insulin resistant, have insulin secretory defects, and are at high risk for glucose intolerance. We performed this study to determine the prevalence of glucose intolerance and parameters associated with risk for this in PCOS women. Two-hundred and fifty-four PCOS women, aged 14-44 yr, were prospectively evaluated at 2 centers, 1 urban and ethnically diverse (n = 110) and 1 rural and ethnically homogeneous (n = 144). The rural PCOS women were compared to 80 control women of similar weight, ethnicity, and age. A 75-g oral glucose challenge was administered after a 3-day 300-g carbohydrate diet and an overnight fast with 0 and 2 h blood samples for glucose levels. Diabetes was categorized according to WHO criteria. The prevalence of glucose intolerance was 31.1% impaired glucose intolerance (IGT) and 7.5% diabetes. In nonobese PCOS women (body mass index, <27 kg/m2), 10.3% IGT and 1.5% diabetes were found. The prevalence of glucose intolerance was significantly higher in PCOS vs. control women (chi2 = 7.0; P = 0.01; odds ratio = 2.76; 95% confidence interval = 1.23-6.57). Variables most associated with postchallenge glucose levels were fasting glucose levels (P < 0.0001), PCOS status (P = 0.002), waist/hip ratio (P = 0.01), and body mass index (P = 0.021). The American Diabetes Association criteria applied to fasting glucose significantly underdiagnosed diabetes compared to the WHO criteria (3.2% vs. 7.5%; chi2 = 4.7; P = 0.046; odds ratio = 2.48; 95% confidence interval = 1.01-6.69). We conclude that 1) PCOS women are at significantly increased risk for IGT and type 2 diabetes mellitus at all weights and at a young age; 2) these prevalence rates are similar in 2 different populations of PCOS women, suggesting that PCOS may be a more important risk factor than ethnicity or race for glucose intolerance in young women; and 3) the American Diabetes Association diabetes diagnostic criteria failed to detect a significant number of PCOS women with diabetes by postchallenge glucose values.