title: Utility of hemoglobin-A1C in nondiabetic women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Hemoglobin 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.
  
  
  METHODS
  In 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.
  
  
  RESULTS
  Compared 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.
  
  
  CONCLUSIONS
  A1C ≥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.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of California-Davis, Davis, CA 95817 , USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Mortada
authors.forename: Kevin
authors.initials: K
authors.lastname: Comerford
authors.forename: K James
authors.initials: KJ
authors.lastname: Kallail
authors.forename: Sidika E
authors.initials: SE
authors.lastname: Karakas
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D042241:Early Diagnosis; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000209:etiology; D007333:Insulin Resistance; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D050556:Fatty Acid-Binding Proteins; D006442:Glycated Hemoglobin; C493410:FABP4 protein, human; C517652:hemoglobin A1c protein, human