Prevalence of diabetes, impaired glucose tolerance and insulin sensitivity in patients with polycystic ovary syndrome - a long term follow-up
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Background: The aim of this long-term follow-up study was to examine glucose tolerance and insulin sensitivity in middle-aged women previously diagnosed with PCOS in comparison with age-matched healthy controls.
Methods: Women diagnosed with PCOS between 1987 and 1995 were invited for the study. 84 PCOS patients and 87 control subjects, randomly selected from the general population, participated in the study. Anthropometric and metabolic parameters, including an oral glucose tolerance test, were examined.
Results: Eighteen (21.4 %) PCOS patients had type 1 or type 2 diabetes or impaired glucose tolerance at the follow-up investigation, which was significantly more common than in control subjects (4.5 %), p < 0.05. Following the adjustment for BMI, insulin sensitivity measured by the Matsuda insulin sensitivity index was significantly lower in women with PCOS and the insulinogenic index, as a measure of beta-cell function, was elevated in PCOS patients in comparison to control subjects. Furthermore, both women with persisting and resolved PCOS at the follow-up investigation displayed decreased Matsuda insulin sensitivity index and increased insulinogenic index in comparison with control subjects. Women without clinical signs of hyperandrogenism at the index assessment displayed higher fasting insulin and proinsulin plasma concentrations than controls at the follow-up investigation. In addition, they had lower Matsuda insulin sensitivity index and higher insulinogenic index than controls. When adjusted for BMI, there was also a trend towards significantly lower Matsuda insulin sensitivity index and increased insulinogenic index at the follow-up investigation among women who had presented with hyperandrogenism at the index assessment.
Conclusion: IGT and type 2 diabetes occurred more often in PCOS patients. Independent of PCOS phenotype at index assessment and persistence of PCOS symptoms at the follow-up investigation, women with PCOS had lower insulin sensitivity and increased beta-cell function in comparison with control subjects.
Polycystic ovary syndrome, long-term follow-up, insulin sensitivity, impaired glucose tolerance, diabetes
Obstetrics, Gynecology and Reproductive Medicine
Research subject Obstetrics and Gynaecology
IdentifiersURN: urn:nbn:se:uu:diva-123245OAI: oai:DiVA.org:uu-123245DiVA: diva2:313608