Published online August 24, 2009
PEDIATRICS Vol. 124 No. 3 September 2009, pp. e496-e502 (doi:10.1542/peds.2008-2050)
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ARTICLE

Glucose Metabolism in Overweight Hispanic Adolescents With and Without Polycystic Ovary Syndrome

Marcela M. Nur, MD, Ilana M. Newman, MD and Lorena M. Siqueira, MD, MSPH

Division of Adolescent Medicine, Miami Children's Hospital, Miami, Florida

OBJECTIVES: About one third of overweight women with polycystic ovary syndrome (PCOS) have either impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM) by the age of 30. We sought to determine if overweight Hispanic adolescents with PCOS are more likely to be insulin resistant and glucose intolerant than those without PCOS.

METHODS: A retrospective chart review of 101 subjects with PCOS and 40 without PCOS was conducted. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), and fasting glucose/insulin ratio (FGIR) values were calculated by using fasting glucose and insulin levels. Insulin resistance (IR) was defined as a fasting insulin level of >15 µU/mL, a 2-hour insulin level of >75 µU/mL, a HOMA-IR value of >3.16, a QUICKI value of <0.357, and/or a FGIR value of <7.

RESULTS: Of the 101 overweight subjects with PCOS (BMI: 33.2 ± 5.9 kg/m2), 4 had IGT and 2 had DM versus none of the 40 subjects without PCOS (BMI: 32.4 ± 5.3 kg/m2). IR was more frequent in the overweight PCOS than in the overweight non-PCOS group (QUICKI: 68.4% vs 14.3%, P = .014) and FGIR (47.4% vs 0%, P = .024). Of the 6 subjects with glucose intolerance, only the QUICKI value was abnormal in all.

CONCLUSIONS: This retrospective study demonstrated that overweight Hispanic adolescents with PCOS had more IR, IGT and DM than their non-PCOS counterparts. As the QUICKI Index was abnormal in all subjects with IGT and DM, we suggest its use as the first step in deciding which overweight Hispanic adolescents with PCOS should be further tested with an OGTT.

Key Words: Hispanic • adolescents • overweight • insulin resistance • glucose intolerance • polycystic ovary syndrome

Abbreviations: PCOS—polycystic ovary syndrome • IGT—impaired glucose tolerance • DM—diabetes mellitus • HOMA-IR—Homeostasis Model Assessment of Insulin Resistance • QUICKI—Quantitative Insulin Sensitivity Check Index • FGIR—fasting glucose/insulin ratio • IR—insulin resistance • OGTT—oral glucose-tolerance test • FPG—fasting plasma glucose • NFG—normal fasting plasma glucose • IFG—impaired fasting plasma glucose

Accepted Apr 10, 2009.


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