title: Fasting glucose measurement as a potential first step screening for glucose metabolism abnormalities in women with anovulatory polycystic ovary syndrome.
abstract: OBJECTIVE
  Is routine screening by oral glucose tolerance test (OGTT) needed for all women with polycystic ovary syndrome (PCOS)?
  
  
  CONCLUSIONS
  Screening for glucose metabolism abnormalities of PCOS patients by an OGTT could potentially be limited to patients who present with a fasting glucose concentration between 6.1 and 7.0 mmol/l only.
  
  
  BACKGROUND
  Women with PCOS are at increased risk of developing diabetes. This study proposes a stepwise screening strategy for (pre)diabetes for PCOS patients based on risk stratification by fasting plasma glucose.
  
  
  METHODS
  A cross-sectional study of 226 women diagnosed with anovulatory PCOS.
  
  
  METHODS
  A consecutive series of 226 patients, diagnosed with PCOS at the University Medical Centre Utrecht, the Netherlands, were screened for glucose metabolism abnormalities by OGTT (75 g glucose load).
  
  
  RESULTS
  The majority of the 226 women (mean age: 29.6 ± 4.3 years; BMI: 27.3 ± 6.7 kg/m(2); 81% Caucasian) presented with a normal OGTT (169 women (75%)). Of the 57 (25%) women presenting with mild to moderate glucose abnormalities, 53 (93%) could be identified by fasting glucose concentrations only. Diabetes was diagnosed in a total of eight women (3.5%). In six women, the diagnosis was based on fasting glucose >7.0 mmol/l. The other two cases of diabetes initially presented with fasting glucose between 6.1 and 7.0 mmol/l and were diagnosed by OGTT assessment. No women diagnosed with diabetes presented with fasting glucose levels below 6.1 mmol/l. We therefore conclude that all diabetes patients could potentially be found by initial fasting glucose assessment followed by OGTT only in patients with fasting glucose between 6.1 and 7.0 mmol/l.
  
  
  CONCLUSIONS
  Before general implementation can be advised, this screening algorithm should be validated in a prospective study of a similar or greater number of PCOS women.
  
  
  CONCLUSIONS
  Our study comprised of a mostly Caucasian (81%) population, therefore generalization to other ethnic populations should be done with caution.
  
  
  BACKGROUND
  No external finance was involved in this study. B.C.J.M.F. has received fees and grant support from the following companies (in alphabetic order); Andromed, Ardana, Ferring, Genovum, Merck Serono, MSD, Organon, Pantharei Bioscience, PregLem, Schering, Schering Plough, Serono and Wyeth. A.J.G. has received fees from Abbott, Bayer Schering and IBSA. T.W.H. has received fees from Merck, Sharpe & Dohme, GlaxoSmithKline, NovoNordisk and Eli Lilly. The authors declare complete independence from funders.
  
  
  BACKGROUND
  NCT00821379.
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, P.O. Box 85500, Utrecht 3508 GA, The Netherlands. veltmanverhulst@gmail.com
authors.forename: Susanne M
authors.initials: SM
authors.lastname: Veltman-Verhulst
authors.forename: Angelique J
authors.initials: AJ
authors.lastname: Goverde
authors.forename: Timon W
authors.initials: TW
authors.lastname: van Haeften
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000378:metabolism
chemical_list: D001786:Blood Glucose
keywords: OGTT; diabetes; fasting; glucose; polycystic ovary syndrome