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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome
Fertility and Sterility, Volume 96, No. 4, Year 2011
Notification
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Description
Objective: To compare screening strategies for type 2 diabetes mellitus (DM), impaired glucose tolerance (pre-DM), and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Academic reproductive endocrinology practice. Patient(s): Adult women with PCOS (n = 111). Intervention(s): None. Main Outcome Measure(s): Subjects were screened for pre-DM and DM using a 2-hour glucose tolerance test (GTT), hemoglobin A1c (HbA1c), or fasting plasma glucose (FPG) and for IR using homeostasis model assessment (HOMA), insulin levels (fasting and 2 hours after 75 glucose load), or obesity. Screening approaches were compared using positive and negative percent agreement and Cohen's kappa (κ). Result(s): DM and pre-DM were diagnosed by GTT in 4% and 20% of subjects, respectively. Screening with FPG failed to identify 41% of pre-DM and 20% of DM subjects. GTT and HbA1c had only fair agreement (κ = 0.29). IR was diagnosed in 24% of subjects with pre-DM or DM and in 56% of the remaining subjects using HOMA and insulin levels. HOMA and elevated insulin levels demonstrated substantial agreement for detecting IR (κ = 0.70-0.73). Obesity demonstrated fair to slight agreement (κ = 0.33-0.18). Conclusion(s): Women with PCOS should be screened for Pre-DM and DM using GTT or HbA1c, and those with Pre-DM or DM are presumed to have IR. In the rest, IR can be detected using either HOMA or insulin levels. © 2011 American Society for Reproductive Medicine, Published by Elsevier Inc.
Authors & Co-Authors
Hurd, William W.
United States, Cleveland
University Hospitals Case Medical Center
Abdel-Rahman, Mohamed Y.
United States, Cleveland
University Hospitals Case Medical Center
Egypt, Sohag
Faculty of Medicine
Ismail, Salah Ali
Egypt, Sohag
Faculty of Medicine
Abdellah, Moustafa A.
Egypt, Sohag
Faculty of Medicine
Schmotzer, Christine L.
United States, Cleveland
University Hospitals Case Medical Center
Sood, Ajay
United States, Cleveland
University Hospitals Case Medical Center
Statistics
Citations: 36
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1016/j.fertnstert.2011.07.002
ISSN:
00150282
e-ISSN:
15565653
Research Areas
Health System And Policy
Noncommunicable Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Participants Gender
Female