Prevalence of Impaired Glucose Tolerance in Adolescent Patients with Polycystic Ovary Syndrome in an Urban Health Care Center

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting young women and has been associated with an increased risk of impaired glucose tolerance and type 2 diabetes mellitus. However, there is scarce pediatric literature on glucose abnormalities in adolescent patients with PCOS. The study objective was to examine the prevalence of abnormal glucose metabolism in the evaluation of diabetes risk in this patient population. Methods: A retrospective analysis of female patients aged 11-18 years who were evaluated for PCOS at the Pediatric Endocrinology clinics of Weill Cornell Medicine between January 2002 and December 2017 and underwent a 75-g oral glucose tolerance test (OGTT) at our institution. Patients with abnormal glucose tolerance were identified by blood glucose level of > 140 mg/dl at 2 hours on the OGTT and impaired fasting glucose was defined as blood glucose level of 100-125 mg/dl as per American Diabetes Association (ADA) criteria. Results: We utilized a sample size of 286 patients with PCOS diagnosis; 111 patients had OGTT results available. Patients on metformin at time of initial visit or at time of OGTT were excluded. 24 patients had impaired glucose tolerance (21%) and 1 patient met criteria for diagnosis of type 2 diabetes mellitus (0.9%). In addition, 2 patients with impaired glucose tolerance were also noted to have impaired fasting glucose (1.8%). Conclusions: In one of the largest adolescent studies to date assessing dysglycemia in PCOS, we describe the prevalence of abnormal glucose metabolism in over one fifth (21.9%) of our patient population. Based on our results, we recommend that all pediatric patients with a diagnosis of PCOS undergo formal oral glucose tolerance testing. Further studies are needed to better determine the timing and frequency of this testing, as well as its utility in clinical care. Disclosure J. Gupta: None. Z. Antal: None. M. Censani: None.