Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome  

Oleh:

Hurd, William W. ; Abdel-Rahman, Mohamed Y. ; Ismail, Salah A. ; Abdellah, Mostafa A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 96 no. 04 (Oct. 2011), page 1043-1047.
Topik: : Polycystic ovarian syndrome; type 2 diabetes mellitus; insulin resistance; oral glucose tolerance test; hemoglobin A1c; blood glucose

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

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 (?). 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 (? = 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 (? = 0.70–0.73). Obesity demonstrated fair to slight agreement (? = 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.

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