Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of California-Davis, Davis, CA 95817 , USA.
Endocr Pract. 2013 Mar-Apr;19(2):284-9. doi: 10.4158/EP12123.OR.
Hemoglobin A1c (A1C) ≥5.7% is now accepted as a biomarker for identifying individuals at risk for diabetes. Compared to the general population, women with polycystic ovary syndrome (PCOS) have a higher risk for diabetes. Our goal was to determine what glucose homeostasis abnormalities can be identified by A1C ≥5.7% in women with PCOS.
In a cross-sectional study, nondiabetic women with PCOS (according to the National Institutes of Health [NIH] criteria) were divided into 2 groups based on A1C (<5.7% [n = 23] and ≥5.7% [n = 25]). Oral glucose tolerance tests (OGTT) and frequently sampled intravenous glucose tolerance tests (FS-IVGTT) were conducted, and body composition, cardiovascular risk factors, and sex steroid levels were assessed.
Compared to women with A1C <5.7%, those with A1C ≥5.7% were older (35.1 ± 1.1 years vs. 31.1 ± 1.1 years; P = .04), had higher glucose levels at fasting and during OGTT, and had a lower insulin sensitivity index (SI: 2.0 ± 0.2 vs. 4.2 ± 0.6; P = .0195) and disposition index (DI: 1,014 ± 82 vs. 1,901 ± 217; P = .011) during FS-IVGTT. They also had higher triglycerides, high-sensitivity C-reactive protein (hs-CRP), and fatty acid-binding protein 4 (FABP4) levels. There was no difference in serum androgen levels.
A1C ≥5.7% identified the subgroup of PCOS patients with higher insulin resistance, inadequate compensatory insulin response, impaired glucose disposition, and increased cardiovascular risk factors. Thus, A1C represents an inexpensive and informative biomarker to identify PCOS patients at risk for metabolic abnormalities.
血红蛋白 A1c（A1C）≥5.7%现在被认为是识别糖尿病风险个体的生物标志物。与一般人群相比，多囊卵巢综合征（PCOS）女性患糖尿病的风险更高。我们的目标是确定 A1C≥5.7%在 PCOS 女性中可以识别哪些血糖稳态异常。
在一项横断面研究中，根据美国国立卫生研究院（NIH）标准，将患有 PCOS 的非糖尿病女性（n = 23）分为 A1C<5.7%（<5.7%，n = 25）两组。进行口服葡萄糖耐量试验（OGTT）和频繁采样静脉葡萄糖耐量试验（FS-IVGTT），并评估身体成分、心血管危险因素和性激素水平。
与 A1C<5.7%的女性相比，A1C≥5.7%的女性年龄更大（35.1±1.1 岁比 31.1±1.1 岁；P =.04），空腹和 OGTT 时血糖水平更高，胰岛素敏感性指数（SI：2.0±0.2 比 4.2±0.6；P =.0195）和处置指数（DI：1014±82 比 1901±217；P =.011）较低。他们的甘油三酯、高敏 C 反应蛋白（hs-CRP）和脂肪酸结合蛋白 4（FABP4）水平也更高。血清雄激素水平无差异。
A1C≥5.7%可识别出胰岛素抵抗、代偿性胰岛素反应不足、葡萄糖处置受损和心血管危险因素增加的 PCOS 患者亚组。因此，A1C 是一种廉价且信息丰富的生物标志物，可用于识别有代谢异常风险的 PCOS 患者。
