Utility of the Oral Glucose Tolerance Test to Assess Glucose Abnormalities in Adolescents with Polycystic Ovary Syndrome

Nicole Coles; Kimberly Bremer; Sari Kives; Xiuyan Zhao; Jill Hamilton

doi:10.1016/j.jpag.2015.06.004

Utility of the Oral Glucose Tolerance Test to Assess Glucose Abnormalities in Adolescents with Polycystic Ovary Syndrome

J Pediatr Adolesc Gynecol. 2016 Feb;29(1):48-52. doi: 10.1016/j.jpag.2015.06.004. Epub 2015 Jun 11.

Authors

Nicole Coles¹, Kimberly Bremer², Sari Kives², Xiuyan Zhao¹, Jill Hamilton³

Affiliations

¹ Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
² Division of Pediatric Adolescent Gynecology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
³ Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: jill.hamilton@sickkids.ca.

PMID: 26358939
DOI: 10.1016/j.jpag.2015.06.004

Abstract

Study objective: The aim of this study was to examine the prevalence of and risk factors for abnormal glucose metabolism in a large population of adolescents with polycystic ovary syndrome (PCOS). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective chart review was performed of 360 patients who presented to the pediatric gynecology outpatient clinic for evaluation of PCOS between January 2004 and May 2012.

Results: A total of 163 patients fulfilled criteria for a diagnosis of PCOS and had adequate clinical and laboratory data. Twenty-six adolescents (16.0%) had impaired glucose tolerance and 2 patients (1.2%) met criteria for a provisional diagnosis of type 2 diabetes. All 28 subjects with abnormal glucose metabolism were identified using the 2-hour plasma glucose of the oral glucose tolerance test. Conversely, the fasting glucose values only successfully detected 2 patients with hyperglycemia, both of whom also had abnormal 2-hour glucose levels. Adolescents with abnormal glucose metabolism were more likely to have reported a positive family history (P = .02) and had higher body mass index z scores (2.8 ± 1.1 vs 1.8 ± 1.2; P < .01). When patients were classified into normal weight (n = 29) and obese/overweight groups (n = 117), all of the patients with abnormal glucose metabolism were overweight or obese.

Conclusion: In the largest series to date, we describe a prevalence of abnormal glucose metabolism in adolescent patients with PCOS of 17.2%. Abnormal glucose metabolism is associated with many of the known risk factors for metabolic syndrome. Our results support that the oral glucose tolerance test is a superior diagnostic test to assess abnormal glucose levels in overweight and obese adolescents but that this test might have limited utility in normal weight adolescents with PCOS.

Keywords: Adolescents; Diabetes mellitus; Glucose intolerance; Polycystic ovary syndrome.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Blood Glucose / metabolism*
Body Mass Index
Child
Diabetes Mellitus, Type 2 / blood
Diabetes Mellitus, Type 2 / complications
Fasting / blood
Female
Glucose Intolerance / diagnosis*
Glucose Intolerance / epidemiology
Glucose Intolerance / etiology
Glucose Tolerance Test*
Humans
Metabolic Syndrome / etiology
Obesity / blood
Obesity / complications
Overweight / blood
Overweight / complications
Polycystic Ovary Syndrome / blood*
Polycystic Ovary Syndrome / complications
Prevalence
Retrospective Studies
Risk Factors

Substances

Blood Glucose