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

Publication ,  Journal Article
Hurd, WW; Abdel-Rahman, MY; Ismail, SA; Abdellah, MA; Schmotzer, CL; Sood, A
Published in: Fertil Steril
October 2011

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.

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Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

October 2011

Volume

96

Issue

4

Start / End Page

1043 / 1047

Location

United States

Related Subject Headings

  • Young Adult
  • Prospective Studies
  • Polycystic Ovary Syndrome
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Mass Screening
  • Insulin Resistance
  • Humans
  • Glycated Hemoglobin
  • Glucose Tolerance Test
 

Citation

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Chicago
ICMJE
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Hurd, W. W., Abdel-Rahman, M. Y., Ismail, S. A., Abdellah, M. A., Schmotzer, C. L., & Sood, A. (2011). Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome. Fertil Steril, 96(4), 1043–1047. https://doi.org/10.1016/j.fertnstert.2011.07.002
Hurd, William W., Mohamed Y. Abdel-Rahman, Salah A. Ismail, Mostafa A. Abdellah, Christine L. Schmotzer, and Ajay Sood. “Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome.Fertil Steril 96, no. 4 (October 2011): 1043–47. https://doi.org/10.1016/j.fertnstert.2011.07.002.
Hurd WW, Abdel-Rahman MY, Ismail SA, Abdellah MA, Schmotzer CL, Sood A. Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome. Fertil Steril. 2011 Oct;96(4):1043–7.
Hurd, William W., et al. “Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome.Fertil Steril, vol. 96, no. 4, Oct. 2011, pp. 1043–47. Pubmed, doi:10.1016/j.fertnstert.2011.07.002.
Hurd WW, Abdel-Rahman MY, Ismail SA, Abdellah MA, Schmotzer CL, Sood A. Comparison of diabetes mellitus and insulin resistance screening methods for women with polycystic ovary syndrome. Fertil Steril. 2011 Oct;96(4):1043–1047.
Journal cover image

Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

October 2011

Volume

96

Issue

4

Start / End Page

1043 / 1047

Location

United States

Related Subject Headings

  • Young Adult
  • Prospective Studies
  • Polycystic Ovary Syndrome
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Mass Screening
  • Insulin Resistance
  • Humans
  • Glycated Hemoglobin
  • Glucose Tolerance Test