Objective: In this study we analysed the prediabetes incidence in women with polycystic ovary syndrome (PCOS), as well as prediabetes and cardiovascular disease (CVD) risk factors in women with PCOS.
Methods: This study included 148 women with PCOS, with no type 2 diabetes mellitus (T2DM) and CVD present at the baseline. We determined a comprehensive panel of biochemical parameters, including lipid profile, glucose and insulin levels during oral glucose tolerance test, levels of C-reactive protein (CRP), steroids, 25-hydroxyvitamin D (25OHD), lipid accumulation product (LAP), prolactin, TSH, and parathyroid hormone.
Results: Prediabetes was present in 18% of PCOS women and it progressed to T2DM in 3% of the cases during the three-years follow-up period. The incident prediabetes was noted in 32% or 4.7/1000 person/year. It was more common in PCOS patients with high BMI as compared to women with normal weight (P=0.007). There was a significant association of prediabetes incidence with levels of CRP (P<0.001), LAP (P=0.001), 25OHD (P=0.016) as well as insulin resistance index (P<0.001). The prediabetes incidence was higher among participants whose baseline levels of CRP, HOMA-IR, and LAP were in the highest versus the lowest tertile (P<0.001). The lowest and middle tertile of 25OHD were associated with prediabetes incidence (P<0.05). The results appear to show that CRP (P<0.05) and LAP (P<0.01) are the most important predictors of cardiovascular risk in PCOS.
Conclusion: Our results demonstrated the high incidence of prediabetes in PCOS women, its strong association with BMI, insulin resistance, markers of inflammation, and LAP, as well as its inverse association with serum 25OHD concentration. The evaluation of the prediabetes risk factors showed that the insulin resistance is more important than other predictors, while the most important predictors of CVD risk in PCOS women were CRP and LAP.