Prevalence of polycystic ovarian changes and polycystic ovary syndrome in premenopausal women with treated type 2 diabetes mellitus

Abstract

Objective: To investigate the prevalence of polycystic ovary syndrome (PCOS) and polycystic ovary (PCO) among premenopausal women with type 2 diabetes mellitus (DM).

Design: Case-control study of women with type 2 DM.

Setting: Tertiary referral university hospital.

Patient(s): Ninety-two premenopausal women with DM, >or=30 years of age, and 20 age- and body mass index-matched healthy premenapousal eumenorrheic women were recruited into the study.

Intervention(s): An oral glucose tolerance test was performed according to the American Diabetes Association criteria for each healthy woman. After an overnight fasting, blood samples were obtained for the determination of fasting blood glucose, LH, FSH, free T, androstenedione (A(4)), 17-hydroxyprogesterone (17-OHP), DHEAS, PRL, free T(4), TSH, E(2), and sex hormone-binding globulin (SHBG) levels. A GnRH analog (buserelin) test was carried out in 36 patients with DM and PCO (including PCOS subjects), 20 patients with DM without PCO or PCOS, and 20 healthy subjects.

Main outcome measure(s): The prevalence of PCO and PCOS in women with type 2 DM.

Result(s): Fifty-seven (62%) of diabetic patients had normal ovaries, 31 (33.7%) had PCO, and 4 (4.3%) had PCOS. The women with DM (n = 92) and healthy women (n = 20) had similar basal A(4), FSH, E(2), 17-OHP, free T, and DHEAS levels. The LH and SHBG levels were lower and the hirsutism score higher in diabetic patients than in healthy women (P<.05). Peak and area under the curve LH and FSH levels after buserelin testing were significantly higher in healthy women than in the patients (P<.05). Peak A(4) levels after buserelin were significantly higher in the patients than in the healthy women (P<.05). Ovarian volume was significantly greater in the patients with PCO (10.1 +/- 0.7 mL) than in the healthy women (7.0 +/- 0.9 mL) (P<.05).

Conclusion(s): We conclude that PCO but not PCOS is a common finding in premenopausal women with type 2 DM. Suppression of gonadotropins, particularly LH secretion, may play a role in the absence of increased PCOS prevalence among type 2 diabetic patients.