title: Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To determine clinically useful predictors of conversion from normal to abnormal glucose tolerance (AGT) in women with polycystic ovary syndrome (PCOS) during regular follow-up, considering that optimal timing for retesting with an oral glucose tolerance test (OGTT) is unknown.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Reproductive endocrinology clinic of an academic center.
  
  
  METHODS
  Glucose-tolerant PCOS women having a follow-up OGTT≥1 year later.
  
  
  METHODS
  Regular clinical follow-up.
  
  
  METHODS
  Sets of criteria associated with the lowest false negative rate and an optimal specificity.
  
  
  RESULTS
  Out of 83 women with PCOS, 24.1% converted to AGT during a median follow-up of 3.0 years, including 3.6% who converted to diabetes. Conversion to AGT was significantly associated with glucose excursion and 2-hour glucose during the normal OGTT, increase in fasting glucose (FG) and body mass index during follow-up, and homeostasis model-assessment insulin resistance and FG at follow-up. The best predictive set of criteria was a baseline glucose excursion of >25 mg/dL or an increase in FG of ≥5%. Using these criteria would have saved 45% of the OGTTs, without missing any conversion to AGT.
  
  
  CONCLUSIONS
  Although our results need to be validated, we determined that using glucose excursion during the previously normal OGTT in combination with another predictor (e.g., increase in FG or glycosylated hemoglobin), could greatly reduce the number of OGTTs performed in PCOS women during their regular follow-ups, with a minimal rate of missed cases.
authors.affiliation: Division of Endocrinology, Department of Medicine, University of Sherbrooke, Quebec, Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Pesant
authors.forename: Jean-Patrice
authors.initials: JP
authors.lastname: Baillargeon
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin