PREVALENCE AND PREDICTORS OF ABNORMAL GLUCOSE TOLERANCE AMONGST WOMEN WITH POLYCYSTIC OVARY SYNDROME IN BENIN CITY

Abstract

BACKGROUND: Polycystic ovary syndrome (PCOS) is a very common gynaecological endocrinopathy with associated ovulatory dysfunction and infertility. Hyperinsulinemia and hyperandrogenism are at the root of the syndrome. By identifying those with hyperinsulinemia and abnormal glucose tolerance (AGT) and offering appropriate therapy, fertility can be restored.
OBJECTIVE: To determine the prevalence of AGT in women with PCOS , attending the Human Reproduction Research Programme/Invitro Fertilisation (HRRP/IVF) Centre, of the University of Benin Teaching Hospital, and to examine the associated risk factors.
METHOD: It was a prospective case control study involving a total of 180 women. All of them attending HRRP/IVF centre of UBTH, for infertility management. Ninety of them constituted PCOS group while the remaining 90 formed the control group. The 75gm Oral glucose tolerance test was administered to women in both groups.
RESULT: The prevalence of AGT amongst women with PCOS was 27.8% while in the control group it was 7.8%. This difference was statistically significant (p<0.0001). Women with PCOS were significantly younger than the control with mean age of 32.9 versus 35.1 years respectively (p=0.01). Both groups had similar weight and BMI. Women with PCOS had significantly higher waist circumference and higher waist/hip ratio with P values of <0.001 each. Age ≥ 30years in women with PCOS was associated with increased risk of AGT. This was statistically significant (p<0.001). Other significant associations with AGT, were waist circumference >88cm, waist/hip ratio >0.8 Body mass Index >30mg/m2. Family history of diabetes mellitus did not increase the risk of AGT in women with PCOS. Similarly Hirsutism, Oligomenorrhea, Polycystic ovaries on ultrasound scan were not predictive of increased risk of AGT in women with PCOS.
CONCLUSION AND RECOMMENDATION It is our conclusion that the prevalence of AGT amongst women with PCOS in Benin City is high. Based on this high prevalence we recommend the performance of 75gm Oral glucose tolerance test (OGTT) as a screening test for AGT in women with PCOS, especially those above the age of 30 years. In the absence of facilities for OGTT or financial difficulties we recommend the routine use of insulin sensitising agents like metformin especially, where PCOS is associated with risk factors for AGT such as waist circumference >88cm; waist/hip ratio >0.8 and BMI >30kg/m2.

PREVALENCE AND PREDICTORS OF ABNORMAL GLUCOSE TOLERANCE AMONGST WOMEN WITH POLYCYSTIC OVARY SYNDROME IN BENIN CITY