Department of Reproductive Medicine, Division of Gynecology and Obstetrics, Oslo University Hospital, Oslo, Norway.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Hum Reprod. 2017 Nov 1;32(11):2279-2286. doi: 10.1093/humrep/dex294.
Is oral glucose tolerance test (OGTT) needed in all women with polycystic ovary syndrome (PCOS)?
OGTT is not routinely needed in women with PCOS and BMI < 25 kg/m2.
PCOS is associated with insulin resistance and increased prevalence of prediabetes and Type 2 diabetes (T2D) which is closely linked to obesity and possibly age, ethnicity and PCOS phenotype. Several guidelines recommend OGTT upon diagnosis of PCOS and during follow-up.
STUDY DESIGN, SIZE, DURATION: A Nordic cross-sectional study including 876 women.
PARTICIPANTS/MATERIALS, SETTING, METHODS: The 876 Nordic women with PCOS, aged 14-57 years, were examined for T2D and prediabetes (impaired glucose tolerance [IGT] or impaired fasting glucose (IFG) by OGTT.
Of all study subjects 3% (23/876) had T2D, 23% (204/876) prediabetes and 74% (649/876) had normal glucose tolerance (NGT). Increased BMI and waist circumference were significantly (P < 0.001) associated with prevalence of prediabetes and T2D. No normal-weight woman (BMI < 25 kg/m2) was diagnosed with T2D. The prevalence of BMI ≥ 25 kg/m2 was 66% (578/ 876). 91% of women (21/23) with T2D had BMI ≥ 30 kg/m2. Testosterone levels and PCOS phenotype did not predict 2-h glucose levels during OGTT after adjustment for BMI and age.
LIMITATIONS, REASONS FOR CAUTION: The present study included cross-sectional data and prospective studies are needed to confirm our results. These results may not apply to populations of other ethnic origin.
Routine OGTT may not be indicated in normal-weight women with PCOS.
STUDY FUNDING/COMPETING INTEREST(S): None.
N/A.
多囊卵巢综合征（PCOS）患者是否都需要进行口服葡萄糖耐量试验（OGTT）？
对于 BMI<25kg/m2 的 PCOS 患者，OGTT 通常不需要。
PCOS 与胰岛素抵抗以及糖尿病前期和 2 型糖尿病（T2D）的患病率增加有关，这些与肥胖以及可能的年龄、种族和 PCOS 表型有关。一些指南建议在诊断 PCOS 时以及在随访期间进行 OGTT。
研究设计、规模、持续时间：这是一项北欧的横断面研究，共纳入 876 名女性。
参与者/材料、设置、方法：876 名患有 PCOS 的北欧女性年龄在 14-57 岁之间，通过 OGTT 检查 T2D 和糖尿病前期（IGT 或 IFG）。
在所有研究对象中，3%（23/876）患有 T2D，23%（204/876）患有糖尿病前期，74%（649/876）有正常葡萄糖耐量（NGT）。BMI 和腰围的增加与糖尿病前期和 T2D 的患病率显著相关（P<0.001）。没有正常体重的女性（BMI<25kg/m2）被诊断为 T2D。BMI≥25kg/m2 的患病率为 66%（578/876）。91%（21/23）患有 T2D 的女性 BMI≥30kg/m2。调整 BMI 和年龄后，23 名 T2D 患者中，有 91%（21/23）的患者 2 小时血糖水平与睾酮水平和 PCOS 表型无关。
局限性、谨慎原因：本研究包括横断面数据，需要前瞻性研究来证实我们的结果。这些结果可能不适用于其他种族的人群。
对于 BMI 正常的 PCOS 女性，OGTT 可能不是必需的。
研究资金/竞争利益：无。
无。
