ESPE Abstracts

Introduction: Glucose tolerance and beta cell function can be abnormal in polycystic ovary syndrome (PCOS) patients because of obesity and/or PCOS per se.

Methods: Various indices derived from 2 hours oral glucose tolerance test (OGTT) were compared in 46 adolescents with PCOS (mean age 17.6 +1.9 years and mean body mass index (BMI) 24.5 +5.4 kg/m²) with age comparable controls (n=25, mean age 19.2 +2.3 and BMI 21.7 +2.8 Kg/m²)

Results: PCOS girls had significantly higher waist circumference (WC) (80.4+11.6 vs 72.1+7.0; P=0.006), mean systolic blood pressure (SBP) (116.6+11.1 vs 107.7+7.8; P=0.001) and LDL cholesterol (115.7+37.2 vs 90.3+21.4; P=0.008) as compared to controls. Fifty percent of PCOS girls had WC >80 cms and about 60% were overweight or obese (BMI>80^th centile for Indian standard). The prevalence of impaired glucose tolerance according to ADA criteria (4/46 in PCOS versus 2/25 in controls) and metabolic syndrome according to ATP III criteria (3/45 vs 0/25) was similar in PCOS girls and controls. The area under curve (AUC) for glucose was similar in both groups (median, range 135, 66-189). AUC for insulin (median, range, 696, 452-1790 versus 126, 670-1383; P=0.01), fasting c-peptide in nmol/L ( median, range 4.4, 0.4 to 182.6 versus 0.6, 0.4 to 1.3, P=0.002) and delta c peptide at 30 minutes from baseline (10.5, 1.6-15.6 versus 1.7, 0.5-5.1; P=0.006) was significantly higher in PCOS as compared to controls. The fasting c-peptide correlated significantly with the delta c-peptide at 30 minutes (r²=.79, P=0.01) There was no difference in the anthropometric measurements, metabolic parameters and the AUC for glucose and insulin derived from OGTT between obese or lean and normal weight PCOS adolescents. Disposition index an estimate of beta cell response to prevailing insulin sensitivity was similar in obese and lean and normal weight PCOS girls.

Conclusions: In this cohort of adolescents with PCOS from North India glucose tolerance was maintained with higher insulin secretion as evidenced with higher AUC for insulin, higher fasting c-peptide and higher delta of c peptide at 30 minutes signifying underlying beta cell dysfunction. Metabolic abnormalities and beta cell dysfunction seen in this cohort of PCOS is likely due to the PCOS status than obesity.