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OGTT follow-up unnecessary in women with PCOS plus lean BMI

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ORLANDO, Fla. — A second oral glucose tolerance test may not be necessary in women with polycystic ovary syndrome who have a BMI less than 25 kg/m² and have not developed type 2 diabetes.

Rasa Pelanis, of Oslo University Hospital in Norway, and colleagues evaluated 1,068 premenopausal women with PCOS to determine the risk for type 2 diabetes and prediabetes. Most participants were white European (n = 839), 69 were Indian/Pakistani and 160 were other ethnicities.

Rasa Pelanis

Baseline fasting glucose and 2-hour glucose were measured using a 2-hour oral glucose tolerance test.

Overall, 356 participants had BMI less than 25 kg/m², 271 had BMI 25 to 30 kg/m² and 438 had BMI greater than 30 kg/m².

Type 2 diabetes was diagnosed in no participants with BMI less than 25 kg/m², 1.5% of those with BMI 25 to 30 kg/m², and 6.4% with BMI of 30 kg/m² or more. Prediabetes was diagnosed in 13.2% of participants with BMI less than 25 kg/m², 27.8% with BMI 25 to 30 kg/m² and 54.6% with BMI of 30 kg/m² or more.

The risk for type 2 diabetes and prediabetes was associated with BMI and waist-to-hip ratio. Compared with participants of white European ethnicity, participants of Indian/Pakistani ethnicity had a 3.2 times higher risk for type 2 diabetes (P = .006) and a 1.7 times higher risk for prediabetes (P = .002). The prevalence of type 2 diabetes was not associated with age or androgen concentration. The prevalence of prediabetes was significantly associated with older age and lower testosterone.

“In our cross-sectional study including 1,068 fertile women with PCOS, no lean women with BMI less than 25 kg/m² had type 2 diabetes,” Pelanis told Endocrine Today. “However, 12% of caucasian and 29% of Indian/Pakistani [women] had prediabetes. After an initial OGTT, it is not necessary to do a new OGTT during the next few years in patients who did not gain weight.” – by Amber Cox

Reference:

Pelanis R, et al. OR11-6. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.

Disclosures: Pelanis reports no relevant financial disclosures.