Can adiponectin predict abnormal glucose tolerance in Thai women with polycystic ovary syndrome?
OBJECTIVE
To evaluate whether adiponectin levels could predict abnormal glucose tolerance (AGT) in Thai women with polycystic ovary syndrome (PCOS).


METHODS
A 75-g oral glucose tolerance test (OGTT) with fasting adiponectin and insulin (FI) blood sampling in 170 women with PCOS were performed consecutively.


RESULTS
The prevalence of AGT was 45.9%. The body mass index (BMI), waist-to-hip ratio (WHR), fasting glucose and 2-h postload glucose were greater in the PCOS women with AGT than those without AGT (P<0.001). In addition, the PCOS women with AGT had more severe insulin resistance (IR) and lower adiponectin levels than those without AGT. However, the area under the ROC curve of adiponectin and insulin in predicting AGT was smaller than that of homeostatic model of IR (HOMA-IR) (P<0.01). The arbitrary cut-off values at 12 ug/mL of adiponectin, 10 microiu/mL of FI and 2 of HOMA-IR showed the sensitivity and specificity of 80.8% and 33.7%; 87.2% and 34.8%; and 89.7% and 31.5%, respectively. With these cut-off points, 46 (27.1%), 42 (24.7%) and 37 (21.8%) women, respectively, could be eliminated from performing OGTT. However, 15 (19.2%), 10 (12.8%) and 8 (10.3%), respectively, missed the diagnosis. In addition, with WHR and acanthosis nigricans adjustment, HOMA-IR, but not adiponectin, was a significant predictor of AGT.


CONCLUSIONS
Our study demonstrated that almost half of the women with PCOS had AGT. Adiponectin levels were significantly lower in the PCOS women with AGT than those without AGT. However, adiponectin was not shown to be as strong a predictive factor and might not be such an excellent screening test as FI and HOMA-IR.
Weerakiet
Sawaek
S
Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. raswt@mahidol.ac.th
Tingthanatikul
Yada
Y
Boonnag
Pongamorn
P
Wansumrith
Surapee
S
Rattanasiri
Sasivimol
S
Leelaphiwat
Supatra
S
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013785:Thailand
D052242:Adiponectin; D015415:Biomarkers; D007328:Insulin