Women with NIH, non-NIH PCOS have elevated diabetes risk
MedWire News: Premenopausal women with National Institutes of Health (NIH) and non-NIH defined polycystic ovary syndrome (PCOS) have similarly elevated risks for diabetes compared with controls.
Lisa Moran (Monash University, Victoria, Australia) and colleagues recruited 54 overweight women (body mass index [BMI] above 25 kg/m2) with PCOS - 29 with NIH PCOS and 25 with non-NIH PCOS - and 27 healthy controls to assess risk for diabetes using anthropometric measures, the oral glucose tolerance test (OGTT), and the Finnish Diabetes Risk Score (FINDRISC).
Women with NIH PCOS had a higher mean BMI (36.1 kg/m2) and waist circumference (104.1 cm) than women with non-NIH PCOS (32.5 kg/m2 and 99.7 cm, respectively) and controls (28.7 kg/m2 and 89.9 cm, respectively). However, women with either form of PCOS had higher 120-minute serum glucose levels (OGTT) than controls, at 5.7 and 5.7 mmol/l versus 5.0 mmol/l, respectively.
The team found that women with NIH and non-NIH PCOS had higher FINDRISC scores than controls, at 11.3 and 10.4 versus 7.6, respectively.
FINDRISC is based on the presence of eight diabetes risk factors, including age, BMI, and waist circumference. A score of less than 7 indicates a low risk for diabetes, 7-11 a slightly elevated risk, 12-14 a moderate risk, and 15 or above a high risk.
Only 4% and 12% of women with NIH and non-NIH PCOS, respectively, were considered to be at low risk for diabetes compared with 50% of the controls.
Classic or more "severe" NIH-defined PCOS is diagnosed in the presence of hyperandrogenism and anovulatory irregular periods, and has a prevalence of 4-8% in the population.
More recently the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) proposed a new definition comprising two of three PCO features on ultrasound, hyperandrogenism, or anovulatory irregular periods. These new criteria identify a group with 'milder' PCOS phenotypes and the prevalence in the population is higher than for NIH-defined PCOS at 10-18%.
The results of this study suggest that contrary to expectations, women with both the NIH form of PCOS and the milder non-NIH form have similar risks for developing diabetes, independent of BMI or adiposity. But, as expected, this risk is significantly higher than that experienced by women without PCOS.
"Clinically, this highlights non-NIH PCOS as a high risk target group for screening of metabolic risk and suggests the application of similar screening and treatment practices for diabetes mellitus 2 for women with NIH and non-NIH PCOS," write the researchers in the journal Fertility and Sterility.
"This warrants future examination in long-term studies in PCOS," they conclude.
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By Helen Albert