Dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS) compared with women with non-PCOS-related infertility.

The present study investigated dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS). A total of forty-five women (aged 25­40 years) with PCOS and 161 control women (aged 25­43 years) with non-PCOS-related infertility were recruited. Anthropometry, glucose tolerance and sex hormones were determined and dietary intake was assessed. Women with PCOS had lower serum sex hormone-binding globulin and increased BMI, waist:hip ratio, luteinising hormone, ratio of luteinising hormone: follicle-stimulating hormone, testosterone and free androgen index (FAI). Postprandial glucose, fasting insulin and insulin resistance were elevated in women with PCOS. Women with PCOS had reduced energy and carbohydrate intake but higher fat intake. Serum sex hormone-binding globulin level was negatively associated with BMI in both groups and negatively correlated with macronutrient intake in the PCOS group with hyperandrogenism. However, FAI was positively correlated with BMI, waist circumference and glucose metabolic parameters in both groups. Therefore, women with PCOS consume lower energy and carbohydrate compared with those with non-PCOS-related infertility and macronutrient intake is only negatively associated with serum sex hormone-binding globulin level in the PCOS group with hyperandrogenism.

Prevalence of insulin resistance and determination of risk factors for glucose intolerance in polycystic ovary syndrome: a cross-sectional study of Chinese infertility patients.

OBJECTIVE: To determine the prevalence of abnormalities in glucose metabolism in patients with polycystic ovary syndrome (PCOS) and control infertility patients in Taiwan, and to determine the predictive risk factors for PCOS. DESIGN: Cross-sectional study. SETTING: Infertility Center, Taiwan Adventist Hospital. PATIENT(S): Three hundred fifty-six patients with PCOS and 974 control infertility patients. INTERVENTION(S): None. MAIN OUTCOMES MEASURE(S): Hormone assay and 75-g oral glucose tolerance test. RESULT(S): Patients with PCOS were younger (32.7 vs. 35.3 years) with a higher body mass index (BMI) (22.4 vs. 20.6 kg/m(2)) than controls. Even after BMI adjustment, patients with PCOS still had significantly higher fasting glucose (97.2 vs. 94.4 mg/dL), fasting insulin (5.6 vs. 4.1 microIU/mL), 2-hour glucose (108.1 vs. 96.0 mg/dL), and 2-hour insulin levels (38.0 vs. 27.0 microIU/mL), and higher homeostasis model assessment of insulin resistance (HOMA-IR) values (1.3 vs. 1.0) than control patients. The prevalence of impaired glucose tolerance and diabetes mellitus in patients with PCOS was 7.6% and 3.1%, respectively, compared with 2.9% and 0.2% in the control group, respectively. Only fasting glucose and insulin, 2-hour insulin, HOMA-IR, age, androstenedione, and status (PCOS vs. control) had a significant impact on 2-hour glucose level. However, BMI and waist/hip ratio did not show a significant impact on 2-hour glucose level. CONCLUSION(S): Chinese women with PCOS are at increased risk for insulin resistance and glucose intolerance compared with controls. Body mass index failed to show significant impact on 2-hour glucose levels in our infertility patients.

Abnormal preconception oral glucose tolerance test predicts an unfavorable pregnancy outcome after an in vitro fertilization cycle.

OBJECTIVE: To determine the relationship between the 75-g oral glucose tolerance test and pregnancy outcome after women's first IVF cycle. DESIGN: Prospective study. SETTING: Infertility center at a private tertiary hospital in Taiwan. PATIENT(S): All 280 patients who went through their initial IVF cycle at the hospital between January 2004 and April 2005 were included in the study. INTERVENTION(S): Two hundred eighty patients underwent an oral glucose tolerance test before entering an IVF cycle; all pregnancy outcomes and pregnancy complications were recorded. MAIN OUTCOME MEASURE(S): The relationships between glycemic parameters and insulin resistance and IVF pregnancy outcome were determined. Linear regression between birth weight and levels of preconception fasting insulin, 2-hour glucose, and 2-hour insulin was performed. RESULT(S): One hundred twenty patients conceived after their initial IVF cycle. Twenty-five of 89 ongoing pregnancies had various complications. The most common pregnancy complication was preterm birth (n = 11). These patients had higher body mass index (23.46 vs. 20.97 kg/m(2)); higher fasting glucose (107.36 vs. 95.14 mg/dL), fasting insulin (10.55 vs. 6.20 microIU/mL), and 2-hour glucose (120.55 vs. 99.97 mg/dL) levels; and higher homeostatic model assessment of insulin resistance (3.43 vs. 1.45) than did patients with full-term pregnancies. Linear regression between birth weight and the fasting glucose level and between birth weight and the homeostatic model assessment of insulin resistance had positive correlations. CONCLUSION(S): Before proceeding with IVF, preconception oral glucose tolerance testing is suggested, especially in patients with higher body mass index, to help identify groups who are at high risk for preterm birth.