1. bookVolume 42 (2021): Issue 2 (October 2021)
Journal Details
First Published
08 Sep 2014
Publication timeframe
2 times per year
access type Open Access

Prevalence and Predictors of Impaired Glucose Tolerance and Diabetes Mellitus Type 2 in Patients with Polycystic Ovary Syndrome

Published Online: 26 Oct 2021
Page range: 61 - 70
Journal Details
First Published
08 Sep 2014
Publication timeframe
2 times per year

Aim: To estimate the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus type 2 (DMT2), as well as the predictors for glucose abnormalities in women with polycystic ovary syndrome (PCOS).

Material and methods: A cross-sectional study with 80 consecutive patients with newly diagnosed PCOS who underwent the standard 75g oral glucose tolerance test (OGTT) and the measurement of sex steroid hormone and lipid profile.

Results: According to the results from the OGTT, 63% had a normal test (NT), 23% had IGT, and 9% had DMT2. The NT group was younger with lower BMI than IGT and DMT2 groups (25.1 ± 7.3, 31.5 ± 6.5, 37.4 ± 4.0 years, and 29.1 ± 8.3 kg/m2, 31.7 ± 4.6 kg/m2, and 34.5 ± 5.6 kg/m2, respectively). The testosterone levels were highest in the group with a normal test (2.7 ± 0.8 nmol/l) and lowest in the DMT2 group (1.9 ± 0.8 nmol/L), with statistical significance. The sex hormone bounding globulin (SHBG) levels were low in all three groups, with statistically significant differences between NG and IGT, and the NT and DMT2 groups. The multivariate linear regression model identified age, BMI, SHBG and testosterone as major independent predictors for abnormal glucose metabolism.

Conclusion: It seems that the prevalence of IGT and DMT2 among PCOS women in our country is not as high as in Western countries. Age, BMI, and SHBG increase the risk for the development of IGT and DMT2. Thus, close monitoring of older, obese women with low SHBG is needed because of the higher risk for the development of IGT and DMT2 in such patients.


1. Dunaif A, Segal KR, Shelley DR, et al. Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes 1992;41:1257-1266.10.2337/diab.41.10.1257 Search in Google Scholar

2. Nolan CJ, Prentki M. Insulin resistance and insulin hypersecretion in the metabolic syndrome and type 2 diabetes: Time for a conceptual framework shift. Diabetes & Vascular Disease Research 2019; Vol. 16(2) 118–127.10.1177/1479164119827611 Search in Google Scholar

3. Mc Carthy CR, Marshall JC. Polycystic ovary syndrome. New England Journal of Medicine 2016; 375: 54-64. (https://doi.org/10.1056/NEJMcp1514916) Search in Google Scholar

4. Bajuk Studen K, Pfeifer M. Cardiometabolic risk in polycystic ovary syndrome. Endocrine Connections 2018; 7(7): 238-251.10.1530/EC-18-0129 Search in Google Scholar

5. Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What's new? Adv Clin Exp Med. 2017; 26(2):359-367.10.17219/acem/59380 Search in Google Scholar

6. Otto-Buczkowska E, Grzyb K, Jainta N. Polycystic ovary syndrome (PCOS) and the accompanying disorders of glucose homeostasis among girls at the time of puberty. Pediatr Endocrinol Diabetes Metab. 2018; 24(1):40-44.10.18544/PEDM-24.01.0101 Search in Google Scholar

7. Tomlinson J. Polycystic ovary syndrome: Why are women at increased risk of type 2 diabetes? Journal of Diabetes Nursing 2016; 3: 91-97. Search in Google Scholar

8. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nature Reviews Disease Primer 2016; 2:16057. (https://doi.org/101038/nrdp.20116.57)10.1038/nrdp.2016.57 Search in Google Scholar

9. Gambineri A, Pelusi C, Manicardi E, et al. Glucose intolerance in a large cohort of mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Diabetes 2004; 53:2353–2358.10.2337/diabetes.53.9.2353 Search in Google Scholar

10. Achard C, Thiers J. Le virilisme pilaire et son association a l᾿ insuffisance glycolytique (diabetes des femmes a barbe)(In French)Bull Acad Natl Med (Paris) 1921; 86:51-64. Search in Google Scholar

11. Burgan GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in poycystic ovarian disease. J Clin Endocrinol Metab 1980; 50:113-116.10.1210/jcem-50-1-113 Search in Google Scholar

12. Ehrmann DA, Barnes RB, Rosenfield RL, et al. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999; 22: 141-146.10.2337/diacare.22.1.141 Search in Google Scholar

13. Sirman MS, Pate AK. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology 2014; 6: 1-13. Search in Google Scholar

14. Kakoly NS, Khomami MB, Joham AE, et al. Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression. Human Reporoduction Update 2018; 1-13.10.1093/humupd/dmy007 Search in Google Scholar

15. Solomon C, Frank Hu, Dunaif A, et al. Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. JAMA 2001; 286(19): 3421-3426.10.1001/jama.286.19.2421 Search in Google Scholar

16. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction 2004; 19: 41–47.10.1093/humrep/deh098 Search in Google Scholar

17. American Diabetes Association Standards of medical care in diabetes – 2014. Diabetes Care 2014; 37: S14–S80.10.2337/dc14-S014 Search in Google Scholar

18. Legro RS, Kunselman AR, Dodson WC, et al. Prevalence and Predictors of Riskfor Type 2 Diabetes Mellitus and Impaired Glucose Tolerance in Polycystic OvarySyndrome: A Prospective, Controlled Study in 254 Affected Women. Journal of Clinical Endocrinology and Metabolism1999;84:165-169.10.1210/jc.84.1.165 Search in Google Scholar

19. Weerakiet S, Srisombut C, Bunnag P, et al. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome. Int J Gynaecol Obstet 2001;75: 177–184.10.1016/S0020-7292(01)00477-5 Search in Google Scholar

20. Gambineri A, Pelusi C, Manicardi E, et al. Glucose Intolerance in a Large Cohort of Mediterranean Women With Polycystic Ovary Syndrome Phenotype and Associated Factors. Diabetes 2004; Vol. 53: 2353–2358.10.2337/diabetes.53.9.2353 Search in Google Scholar

21. Dabadghao P, Roberts BJ, Wang J, et al. Glucose tolerance abnormalities in Australian women with polycystic ovary syndrome. MJA 2007; 187(6): 328–331.10.5694/j.1326-5377.2007.tb01273.x Search in Google Scholar

22. Apridonidze T, Essah P, Iuorno MJ, et al. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005; 90(4):1929-1935.10.1210/jc.2004-1045 Search in Google Scholar

23. Carmina E, Napoli N, Longo RA, et al. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. European Journal of Endocrinology 2006; 154: 141-145.10.1530/eje.1.02058 Search in Google Scholar

24. Ehrmann DA, Liljenquist DR, Kasza K, et al.Prevalence and predictors of the metabolic syndrome in women with polycystic ovarysyndrome. Journal of Clinical Endocrinology and Metabolism 2006; 91:48-53.10.1210/jc.2005-1329 Search in Google Scholar

25. Moran LJ, Misso ML, Wild RA, et al. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic reviewand meta-analysis. Human Reproduction Update 2010; 16:347-363.10.1093/humupd/dmq001 Search in Google Scholar

26. Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on type 2 diabetes prevention. Diabet Med 2007; 24: 451-463.10.1111/j.1464-5491.2007.02157.x Search in Google Scholar

27. Livadas S, Kollias A, Panidis D, et al. Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome evidence from 1345 women with the syndrome. European Journal of Endocrinology 2014;171: 301-309. (https://doi.org/10.1210/jc.2012-3908) Search in Google Scholar

28. Ciampelli M, Fulghesu AM, Cucinelli F,et al. Impact of insulin and body mass index on metabolic and endocrine variables in polycystic ovary syndrome. Metabolism 1999; 48: 167-172.10.1016/S0026-0495(99)90028-8 Search in Google Scholar

29. Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycysticovary syndrome. Journal of Clinical Endocrinology and Metabolism 2008; 93:162-168.10.1210/jc.2007-1834 Search in Google Scholar

30. Lim SS, Norman RJ, Davies MJ, et al. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obesity Reviews 2013; 14: 95-109.10.1111/j.1467-789X.2012.01053.x Search in Google Scholar

31. Andersen M and Glintborg D. Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT? European Journal of Endocrinology. 2018; 179, D1–D14. Search in Google Scholar

32. Lazaridou S, Dinas K, Tziomalos K. Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome. HORMONES 2017; 16(4):373-380. Search in Google Scholar

33. Barber TM, Vojtechova P, Franks S. The impact of hyperandrogenism in femaleobesity and cardiometabolic diseases associated with polycystic ovary syndrome. Hormone Molecular Biology and Clinical Investigation 2013;15:91-103.10.1515/hmbci-2013-0014 Search in Google Scholar

34. Shorakae S, Teede H, de Courten B, et al. The emerging role of chronic low-grade inflammation in the pathophysiology of polycystic ovary syndrome. Semin Reprod Med 2015; 33:257–269.10.1055/s-0035-1556568 Search in Google Scholar

35. O Reilly WM, Taylor EA, Crabtree JN, et al. Hyperandrogenemia predicts metabolic phenotype in polycystic ovary syndrome: the utility of serum androstenedione. J Clin Endocrinol Metab 2014; 99(3): 1027-1036.10.1210/jc.2013-3399 Search in Google Scholar

36. Thaler MA, Seifert-Klauss V, Luppa PB. The biomarker sex hormone-bindingglobulin - from established applications to emerging trends in clinical medicine. Best Practice & Research: Clinical Endocrinology & Metabolism 2015; 29:749-760.10.1016/j.beem.2015.06.005 Search in Google Scholar

37. Haffner SM, Valdez RA, Morales PA, et al. Decreased sex hormone-binding globulin predicts noninsulin-dependent diabetes mellitus in women but not in men. J Clin Endocrinol Metab 1993; 77: 56–60. Search in Google Scholar

38. Sutton-Tyrrell K, Wildman RP, Matthews KA, et al.Sex Hormone-Binding Globulin and the Free Androgen Index Are Related toCardiovascular Risk Factors in Multiethnic Premenopausal and Perimenopausal Women Enrolled in the Study of Women Across the Nation (SWAN). Circulation 2005;111:1242-1249.10.1161/01.CIR.0000157697.54255.CE Search in Google Scholar

39. Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis S A, et al. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab 2007; 18:280–285.10.1016/j.tem.2007.07.004 Search in Google Scholar

40. Rizzo M, Berneis K, Carmina E, et al. How should we manage atherogenic dyslipidemia in-women with polycystic ovary syndrome? Am J Obstet Gynecol 2008; 198:28.e21–25.10.1016/j.ajog.2007.09.014 Search in Google Scholar

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