Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome
Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome
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DOI：
10.1210/jc.87.3.1017
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发表时间：
2002-03-01
影响因子：
5.8
通讯作者：
Dunaif, A
中科院分区：
文献类型：
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作者：
Palmert, MR;Gordon, CM;Dunaif, A
多囊卵巢综合征（PCOS）患者的胰岛素抵抗是常见的。虽然最近的数据表明，胰岛素抵抗存在于PCOS的早期阶段，胰岛素抵抗的患病率在青少年与PCOS尚未确定。同样，青少年组群中葡萄糖耐量受损（IGT）或2型糖尿病（DM）的患病率尚未确定。在这项研究中，我们试图获得初步的数据，IGT和糖尿病的患病率在青少年PCOS和评估能力的筛查测试，以预测这些异常在这个population.Twenty-seven青少年PCOS进行口服葡萄糖耐量试验。在基线时获得血浆葡萄糖和胰岛素水平，并在75 g葡萄糖激发后2小时测量葡萄糖。2小时血糖水平用于将受试者分类为IGT或临时诊断为DM。我们的27名受试者中有8名患有IGT，1名先前未诊断为DM。这些异常在瘦的和肥胖的受试者中观察到。空腹血糖水平和胰岛素抵抗的简单措施是次优的预测IGT和DM在我们的coherent.As在成人，我们的研究结果表明，PCOS青少年是在IGT和DM的风险增加，口服葡萄糖挑战后2小时的血糖水平似乎是最可靠的筛查这些异常。我们的研究结果需要进一步的研究来证实，这些研究确定了大量青少年中葡萄糖耐量异常的患病率，无论是否患有PCOS。然而，由于糖尿病可以通过生活方式的改变来预防，我们建议PCOS青少年定期进行糖耐量异常的筛查，使用2小时后的血糖水平。
Insulin resistance is common in adults with polycystic ovary syndrome (PCOS). Although recent data demonstrate that insulin resistance is present in the early stages of PCOS, the prevalence of insulin resistance in adolescents with PCOS has not been determined. Likewise, the prevalence of impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM) in adolescent cohorts has not been established. In this study we sought to obtain preliminary data regarding the prevalence of IGT and DM in adolescents with PCOS and to assess the ability of screening tests to predict these abnormalities within this population.Twenty-seven adolescents with PCOS underwent oral glucose tolerance tests. Plasma glucose and insulin levels were obtained at baseline, and glucose was measured 2 h after a 75-g glucose challenge. The 2-h plasma glucose level was used to categorize subjects as having IGT or the provisional diagnosis of DM. Eight of our 27 subjects had IGT, and 1 had previously undiagnosed DM. These abnormalities were seen among lean and obese subjects. Fasting plasma glucose levels and simple measures of insulin resistance were suboptimal predictors of IGT and DM within our cohort.As in adults, our results indicate that adolescents with PCOS are at increased risk for IGT and DM and that the 2-h plasma glucose level after an oral glucose challenge appears to be the most reliable screening test for these abnormalities. Our results need to be corroborated by future studies that determine the prevalence of abnormalities in glucose tolerance among large populations of adolescents, both with and without PCOS. However, as DM may be preventable by lifestyle modifications, we would recommend that adolescents with PCOS undergo periodic screening for abnormal glucose tolerance using 2-h postchallenge plasma glucose levels.