Polycystic ovary syndrome and type 2 diabetes mellitus: A state-of-the-art review

Table 1 Incidence of dysglycemia in women with polycystic ovary syndrome

Ref.	Sample size	Country	PCOS criteria	T2D criteria	Age (yr)	BMI (kg/m2)	IFG (%)	IGT (%)	T2D (%)
Rajkhowa et al[142], 1996	90	UK	NIH	WHO	26 (15-39)	31.6 (18-48)	?	9	2
Legro et al[61], 1999	254	USA	NIH	WHO	14-44	32 ± 3	?	31	7.5
Ehrmann et al[62], 1999	122	USA	NIH	ADA	25 ± 0.7 (13-40)	30-43	9	35	10
Gambineri et al[3], 2004	121	Italy	Rotterdam	WHO	14-37	20-38	?	15.7	2.5
Legro et al[143], 2005	71	USA	NIH	ADA	30 ± 6	29 ± 6.4	?	25	10
Chen et al[144], 2006	102	China	Rotterdam	WHO	24.2 ± 6	21.7 ± 4	?	20.5	1.9
Mohlig et al[64], 2006	264	Germany	NIH	WHO	28 ± 0.4	30 ± 0.4	?	14.3	1.5
Vrbikova et al[145], 2007	244	Czech Republic	Rotterdam	ADA	27 ± 7.5	27 ± 6.9	12.3	9.4	1.6
Gagnon et al[146], 2007	105	Canada	NIH	ADA	28.3 (14-47)	35.5 (19-54)	?	23	5
Dabadghao et al[63], 2007	372	Australia	Rotterdam	ADA	30 ± 5 (15-62)	35 ± 8	3	15.6	4
Espinos-Gomez et al[147], 2008	102	Spain	NIH	WHO	26 ± 6	30.2 ± 8	?	10.7	7.7
Cheung et al[148], 2008	295	China	Rotterdam	ADA	30 ± 6	25 ± 5.9	9.2	10.5	7.5
Bhattacharya et al[149], 2009	264	India	Rotterdam	WHO	24 ± 4	27 ± 4.5	?	14.4
Seneviratne et al[15], 2009	168	Sri Lanka	Rotterdam	WHO	29 ± 4 (20–40)	25.92 (16-39)	?	23.2	10.1
Lee et al[50], 2009	194	Korea	Rotterdam	ADA	27 ± 5	24 ± 4	17		1
Wei et al[51], 2009	356	China	Rotterdam	WHO	32 ± 4 (19-44)	22 ± 4.2	?	7.6	3,1
Zhao et al[150], 2010	818	China	Rotterdam	ADA	25 ± 5	?	8.5	35.4	4
Stovall et al[151], 2011	78	USA	NIH	ADA	26 ± 6.4	29 ± 6 (18-43)	2	14	?
Celik et al[66], 2013	252	Turkey	Rotterdam	ADA	24 ± 5	26 ± 5.7	?	14.3	2
Veltman-Verhulst et al[21], 2013	226	Netherlands	Rotterdam	ADA	29.6 ± 4	27 ± 6.7	21	4	3.5
Lerchbaum et al[152], 2014	714	Austria	Rotterdam	ADA	27 (23-32)	24.2 (21-30)	12.8		1.5
Vrbikova et al[145], 2014	330	Czech Republic	Rotterdam	ADA	27.8 ± 7	27.6 ± 6	12	8.8	3
Amato et al[22], 2015	241	Italy	Rotterdam	WHO	24 ± 6 (14-43)	30 ± 6 (18-50)	11.6	5.4	1.7
Ganie et al[14], 2015	2014	India	Rotterdam	ADA	23 ± 5.4	25 ± 4.4	14.5	5.9	6.3
Gracelyn et al[153], 2015	200	India	Rotterdam	ADA	16-40	?	?	14.5	1.5
Li et al[154], 2016	2436	China	Rotterdam	ADA	27	21.56	13.5	19.8	3.9
Ollila et al[127], 2017	265	Finland	Rotterdam	WHO	46	28.6 ± 6	?	?	12.4
Pelanis et al[13], 2017	876	Sweden	Rotterdam	ADA	29 (25-34)	28 (23-33)	11	12	3
Zhang et al[19], 2018	378	China	Rotterdam	IDF	27 ± 4.4	30 ± 4.3	31.5		8.7
Ortiz-Flores et al[155], 2019	400	Spain	Rotterdam	WHO	26 (14-49)	28.6 (22-34)	14	14.5	2.5

NIH: National Institutes of Health; T2D: Type 2 diabetes mellitus; PCOS: Polycystic ovary syndrome; ADA: American Diabetes Association; WHO: World Health Organization.

Table 2 Guidelines regarding oral glucose tolerance test upon diagnosis of Polycystic ovary syndrome

Ref.	OGTT recommended upon diagnosis in all women with PCOS	Follow-up with OGTT
Joint AACE/ACE and AE-PCOS society[56]	Yes	(1) Yearly in women with IGT; and (2) Every 1–2 years based on BMI (not specified) and family history of T2D
Australian NHMRC[57]	Recommended if one or more criteria exist: (1) BMI > 25 kg/m2 or in Asians > 23 kg/m2; (2) History of IFG, IGT, GDM; (3) Family history of T2D; (4) Arterial hypertension; and (5) High-risk ethnicity	Every 1-3 years, based on presence of other diabetesrisk factors
Endocrine Society[55]	Yes	Every 3–5 years (Sooner if additional risk factors for T2D develop)
Royal College of Obstetricians andGynecology[59]	Recommended if one or more criteria exist: (1) BMI ≥ 25 kg/m2; (2) Age ≥ 40 years; (3) Previous GDM; and (4) Family history of T2D	Yearly in women with IGT or IFG
AE-PCOS Society[58]	Recommended if one or more criteria exist: (1) BMI ≥ 30 kg/m2; (2) Age ≥ 40 years; (3) Previous GDM; and (4) Family history of T2D	Every 2 years in women with risk factors (Sooner if additional risk factors for T2D develop)
ESHRE and ASRM[60]	Recommended if BMI ≥ 27 kg/m2	Not specified

OGTT: Oral glucose tolerance test; PCOS: Polycystic ovary syndrome; T2D: type 2 diabetes mellitus; BMI: Body mass index; IFG: Impaired fasting glucose; IGT: Impaired glucose tolerance.