title: Utility of the Oral Glucose Tolerance Test to Assess Glucose Abnormalities in Adolescents with Polycystic Ovary Syndrome.
abstract: OBJECTIVE
  The aim of this study was to examine the prevalence of and risk factors for abnormal glucose metabolism in a large population of adolescents with polycystic ovary syndrome (PCOS). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective chart review was performed of 360 patients who presented to the pediatric gynecology outpatient clinic for evaluation of PCOS between January 2004 and May 2012.
  
  
  RESULTS
  A total of 163 patients fulfilled criteria for a diagnosis of PCOS and had adequate clinical and laboratory data. Twenty-six adolescents (16.0%) had impaired glucose tolerance and 2 patients (1.2%) met criteria for a provisional diagnosis of type 2 diabetes. All 28 subjects with abnormal glucose metabolism were identified using the 2-hour plasma glucose of the oral glucose tolerance test. Conversely, the fasting glucose values only successfully detected 2 patients with hyperglycemia, both of whom also had abnormal 2-hour glucose levels. Adolescents with abnormal glucose metabolism were more likely to have reported a positive family history (P = .02) and had higher body mass index z scores (2.8 ± 1.1 vs 1.8 ± 1.2; P < .01). When patients were classified into normal weight (n = 29) and obese/overweight groups (n = 117), all of the patients with abnormal glucose metabolism were overweight or obese.
  
  
  CONCLUSIONS
  In the largest series to date, we describe a prevalence of abnormal glucose metabolism in adolescent patients with PCOS of 17.2%. Abnormal glucose metabolism is associated with many of the known risk factors for metabolic syndrome. Our results support that the oral glucose tolerance test is a superior diagnostic test to assess abnormal glucose levels in overweight and obese adolescents but that this test might have limited utility in normal weight adolescents with PCOS.
authors.affiliation: Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Coles
authors.affiliation: Division of Pediatric Adolescent Gynecology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Bremer
authors.affiliation: Division of Pediatric Adolescent Gynecology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sari
authors.initials: S
authors.lastname: Kives
authors.affiliation: Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Xiuyan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: jill.hamilton@sickkids.ca.
authors.forename: Jill
authors.initials: J
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D024821:Metabolic Syndrome / Q000209:etiology; D009765:Obesity / Q000097:blood / Q000150:complications; D050177:Overweight / Q000097:blood / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Adolescents; Diabetes mellitus; Glucose intolerance; Polycystic ovary syndrome