Endocrine Abstracts

Objective: To determine the frequency of polycystic ovary syndrome (PCOS) in women with prediabetes compared to control women.

Methods: Digital screening and tele-interviews remotely excluded 3218 out of 3465 consecutive women applied for routine check-up. In-person assessments were performed on 247 women, excluding 49. Final analyses included 198 premenopausal women without endocrine disorders (other than prediabetes and PCOS) or conditions affecting gonadal functions. Prediabetes and PCOS were determined according to American Diabetes Association and Rotterdam criteria, respectively.

Results: One-hundred women had prediabetes and 98 women had normoglycemia. The frequency of PCOS were 21% and 19.4% in prediabetes and control groups, respectively (P=0.860). PCOS frequency was 32% in impaired glucose tolerance (IGT) only subgroup. Prediabetes group had higher insulin-like growth factor-1(IGF–1) levels and lower anti-Müllerian hormone (AMH) levels (P=0.013 and P=0.016 respectively). Insulin levels were correlated with testosterone, antral follicle count (AFC), and ovarian volume only in prediabetes group (P<0.05 for all). Mediation model in prediabetes group showed that insulin levels increased testosterone levels both directly, and indirectly through increasing IGF-1 levels (b=0.4, P=0.0006).

Conclusion: While risk of PCOS was not increased in overall prediabetes group, a trend for an increased risk in IGT only subgroup was noteworthy. Positive correlation of insulin levels with testosterone levels, AFC, and ovarian volume being only found in prediabetes group suggested that prediabetes might render ovaries susceptible to the PCOS-like changes induced by insulin. The lower AMH levels in prediabetes group, indicating diminished ovarian reserve, implied that even mild hyperglycemia might have deleterious effects on ovaries. The glucotoxicity of prediabetes on ovaries merits further attention.