Women with PCOS often experience insulin resistance, and are at increased risk for developing type 2 diabetes, dyslipidemia, and cardiovascular disease. One cross-sectional study7 of 122 women with PCOS between 13.5 and 40 years of age found that 35% had impaired glucose tolerance, and another 10% had non-insulindependent diabetes. A prospective case-control study8 of young women (aged <35 years) found that compared with age- and BMI-matched controls, those with PCOS had higher levels of fasting glucose, insulin, total and low-density lipoprotein cholesterol, and altered left ventricular mass and cardiac function on echocardiogram. Once PCOS is suspected, the diagnostic work-up should include a 2-hour glucose tolerance test and lipid panel to assess cardiovascular risk, particularly among obese women.
Recommendations from others
A 2002 American College of Obstetricians and Gynecologists guideline9 adopted the 1990 National Institutes of Health consensus panel criteria for diagnosing PCOS (ie, chronic anovulation and clinical or biochemical signs of hyperandrogenism, excluding other causes), and recommends that all patients have documentation of elevated testosterone levels; thyroid-stimulating hormone (TSH), prolactin, and 17-hydroxyprogesterone levels to exclude secondary causes of hyperandrogenism; and evaluation for metabolic abnormalities with a 2-hour glucose tolerance test and fasting lipid panel.