title: Prevalence and possible mechanisms of reactive hypoglycemia in polycystic ovary syndrome.
abstract: OBJECTIVE
  What is the prevalence of reactive hypoglycemia (RH) in polycystic ovary syndrome (PCOS) versus age- and body mass index (BMI)-matched healthy controls.
  
  
  CONCLUSIONS
  The prevalence of RH was increased in PCOS versus controls.
  
  
  BACKGROUND
  Previous studies suggested an increased prevalence of RH in PCOS.
  
  
  METHODS
  Cross-sectional study of 88 women with PCOS and 34 healthy age- and BMI-matched controls.
  
  
  METHODS
  Eighty-eight women with PCOS and 34 age- and BMI-matched controls were included. The study was conducted at Odense University Hospital, Denmark. Participants underwent 5 h oral glucose tolerance test (5 h OGTT). Indices of insulin resistance, β-cell function, and area under the curve (AUC) for glucose, insulin and C-peptide were calculated. Insulin clearance was estimated as 5 h AUC C-peptide/insulin. RH was defined as blood glucose ≤3.3 mmol/l during 5 h OGTT.
  
  
  RESULTS
  RH occurred in 15/88 (17%) women with PCOS versus 0/34 controls ( ITALIC! P = 0.01). Nine out of 15 women with RH were obese and 6 were lean ( ITALIC! P = 0.42). Obese patients with RH had significantly higher 5 h AUCs insulin and C-peptide compared with lean patients with RH ( ITALIC! P = 0.02 and 0.04, respectively). Obese patients with RH had significantly lower 5 h AUC C-peptide/insulin versus obese patients without RH ( ITALIC! P = 0.02). In lean patients with RH, 5 h AUCs insulin and C-peptide were similar to lean controls.
  
  
  CONCLUSIONS
  The 5 h OGTT was used to diagnose RH and may be a limitation of the study. Although the 5 h OGTT is the most widely accepted method, no gold standard exists in terms of diagnosing RH. The 5 h OGTT was suggested to over-estimate the incidence of RH compared with meal test.
  
  
  CONCLUSIONS
  The study supports previous suggestions of increased prevalence of RH in women with PCOS compared with controls.
  
  
  BACKGROUND
  This study was funded by Jacob Madsen's and Olga Madsen's Foundation, Institute of Clinical Research, Odense University Hospital, Kolding Hospital, AP Møller's Foundation, Bernhard and Marie Kleins Foundation, The Novo Nordisk Foundation, and The Danish Medical Association. The authors declare no conflict of interest.
  
  
  BACKGROUND
  The trial was registered at www.clinicaltrials.gov (registration numbers NCT00451568 (patients) and NCT01995773 (controls)).
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark hanne.mumm@rsyd.dk.
authors.forename: Hanne
authors.initials: H
authors.lastname: Mumm
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Magda Lambaa
authors.initials: ML
authors.lastname: Altinok
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Henriksen
authors.affiliation: Department of Gynecology and Obstetrics, Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Ravn
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Glintborg
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin
keywords: 5 h oral glucose tolerance test; insulin; obesity; polycystic ovary syndrome; reactive hypoglycemia