Utility of Hemoglobin-A1C in Nondiabetic Women With Polycystic Ovary Syndrome |
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| Institution: | 1. Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of California-Davis, Davis;2. Department of Internal Medicine, University of Kansas School of Medicine, Wichita, Kansas, and University of California-Davis, Davis;3. Nutritional Biology Graduate Group, Department of Nutrition, University of California-Davis, Davis;1. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada;2. Section of Endocrinology, St. Boniface Hospital, Winnipeg, MB, Canada;3. Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA;4. Department of Medicine, University of Toronto, Toronto, ON, Canada;5. Department of Medicine, University Health Network, Toronto, ON, Canada;6. Faculty of Arts, University of Western Ontario, London, ON, Canada;7. Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON, Canada;8. Division of Endocrinology and Metabolism, Mount Sinai Hospital, Toronto, ON, Canada;1. Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center;2. Division of Nuclear Medicine, Beth Israel Deaconess Medical Center;3. Division of Endocrinology, Harvard Vanguard Medical Associates;1. Department of Dermatology, Allergology, and Venereology, Institute of Clinical Medicine, University of Helsinki, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland;2. Division of Endocrinology, Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan;1. Divisâo de Endocrinologia e Diabetes, Hospital Agamenon Magalhâes - SUS, Universidade de Pernambuco;1. Laboratório de Eletrofisiologia do Hospital das Clínicas de Pernambuco, Universidade Federal de Pernambuco;1. Instituto de Medicina Integral Prof Fernando Figueira, Recife;1. Departamento of Neurosurgery, Hospital da Restauração, SUS/Universidade de Pernambuco, Recife |
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| Abstract: | ObjectiveHemoglobin A1c (A1C) >5.7% is now accepted as a biomarker for identifying individuals at risk for diabetes. Compared to the general population, women with polycystic ovary syndrome (PCOS) have a higher risk for diabetes. Our goal was to determine what glucose homeostasis abnormalities can be identified by A1C >5.7% in women with PCOS.MethodsIn a cross-sectional study, nondiabetic women with PCOS (according to the National Institutes of Health NIH] criteria) were divided into 2 groups based on A1C (<5.7% n = 23] and >5.7% n = 25]). Oral glucose tolerance tests (OGTT) and frequently sampled intravenous glucose tolerance tests (FS-IVGTT) were conducted, and body composition, cardiovascular risk factors, and sex steroid levels were assessed.ResultsCompared to women with A1C <5.7%, those with A1C >5.7% were older (35.1 ± 1.1 years vs. 31.1 ± 1.1 years; P = .04), had higher glucose levels at fasting and during OGTT, and had a lower insulin sensitivity index (SI: 2.0 ± 0.2 vs. 4.2 ± 0.6; P = .0195) and disposition index (DI: 1,014 ± 82 vs. 1,901 ± 217; P = .011) during FS-IVGTT. They also had higher triglycerides, high-sensitivity C-reactive protein (hs-CRP), and fatty acid-binding protein 4 (FABP4) levels. There was no difference in serum androgen levels.ConclusionA1C >5.7% identified the subgroup of PCOS patients with higher insulin resistance, inadequate compensatory insulin response, impaired glucose disposition, and increased cardiovascular risk factors. Thus, A1C represents an inexpensive and informative biomarker to identify PCOS patients at risk for metabolic abnormalities. (Endocr Pract. 2013;19:284-289) |
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