Rezaee Mohsen, Asadi Nasrin, Pouralborz Yasna, Ghodrat Mahshid, Habibi Shaghayegh
Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Pediatr Adolesc Gynecol. 2016 Dec;29(6):562-566. doi: 10.1016/j.jpag.2016.07.001. Epub 2016 Sep 1.
Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine disorders among women of reproductive age, with a variety of complications and consequences mostly due to hyperandrogenism and insulin resistance (IR). PCOS patients with IR are at risk for metabolic syndrome and diabetes mellitus (DM) along with its complications such as cardiovascular events. There are several methods for screening IR in patients with PCOS to predict DM and other complications. Fasting plasma glucose test, oral glucose tolerance test, and insulin and glycosylated hemoglobin (HbA1c) levels are some available screening tools for IR. The American Diabetes Association recommended HbA1c to screen for DM because HbA1c is not affected by day-to-day plasma glucose levels and reflects the plasma glucose status during 2-3 months before measurement. Some studies have evaluated the role of HbA1c as a screening method to predict DM in PCOS patients, however, there are still controversies in this matter. Also some studies reported that HbA1c has a correlation with complications of PCOS such as metabolic syndrome and cardiovascular events. We found that HbA1c could be a suitable screening test for IR in PCOS patients but more studies are recommended, omitting confounding factors that could affect IR in patients with PCOS, such as antihyperglycemic agents like metformin, or lifestyle modification, which can be effective in reducing IR in patients with PCOS.
多囊卵巢综合征（PCOS）是育龄女性中最常见的生殖内分泌疾病之一，其多种并发症和后果主要归因于雄激素过多和胰岛素抵抗（IR）。伴有IR的PCOS患者有患代谢综合征和糖尿病（DM）及其并发症（如心血管事件）的风险。有几种方法可用于筛查PCOS患者的IR，以预测DM和其他并发症。空腹血糖测试、口服葡萄糖耐量测试以及胰岛素和糖化血红蛋白（HbA1c）水平是一些可用的IR筛查工具。美国糖尿病协会推荐使用HbA1c来筛查DM，因为HbA1c不受每日血糖水平的影响，并且反映了测量前2至3个月的血糖状态。一些研究评估了HbA1c作为预测PCOS患者DM的筛查方法的作用，然而，在这个问题上仍然存在争议。此外，一些研究报告称HbA1c与PCOS的并发症（如代谢综合征和心血管事件）相关。我们发现HbA1c可能是PCOS患者IR的合适筛查测试，但建议进行更多研究，排除可能影响PCOS患者IR的混杂因素，如二甲双胍等降糖药物，或生活方式改变，后者可有效降低PCOS患者的IR。
