Background: Women with polycystic ovary syndrome (PCOS) are commonly associated with insulin resistance, metabolic syndrome and a family history of diabetes mellitus (DM). They are therefore at risk of diabetes and dyslipidaemia. Diabetes UK (2006) recommends screening for diabetes in PCOS patients who have a body mass index (BMI) ≥30. The recommended test is fasting plasma glucose (FPG). We therefore investigated 55 PCOS patients and 33 healthy volunteers to test the hypothesis that a high fasting triglycerides (TG)(>1.7 mmol/L) and/or low high-density lipoprotein- cholesterol (HDL)(<1.29 mmol/L) predicts impaired glucose regulation ((IGR) impaired fasting glucose (IFG), impaired glucose tolerance (IGT), DM) in PCOS.
Methods: All participants had a lipid profile and an oral glucose tolerance test following a 12 hour overnight fast.
Results: PCOS patients and healthy controls were well matched for age (mean±S.D.) 31.5±7.1 vs 32.9±8.9 years (P= 0.5), and BMI 34.1±5.8 vs 31.5 ±7.1 kg/m2 (P=0.07). Waist circumference (WC) (103.3±14.7 vs 96.2±16.2 cm), TG (1.3±0.6 vs 1.0±0.5 mmol/L) and postprandial glucose (PPG)(6.3±2.1 vs 5.1±1.5 mmol/L)) were higher, and HDL (1.1±0.27 vs 1.3±0.4 mmol/L) was lower in PCOS than controls (all P<0.05). FPG, total cholesterol and low-density lipoprotein-cholesterol were not different. Only WC independently predicted FPG in both groups (Beta=0.32, P=0.02) vs (Beta=0.39, P=0.03). Only TG (Beta=0.40, P=0.02) in controls, and TG (Beta=0.40, P=0.003) and HDL (Beta=−0.27, P=0.01) in PCOS were independently associated with PPG. Forty, 16 and 12 of 55 PCOS patients had low HDL, high TG, and IGR (IGT=10, DM=2) respectively. All patients with IGR had low HDL and one third of them had high TG. Seventeen and 4 of 33 controls had low HDL, high TG respectively but only one subject had IGT. Conclusions Fasting plasma glucose was insensitive to detect IGR in the study group. The presence of high triglycerides and low HDL in addition to BMI may identify those who should have an OGTT in PCOS.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.