The Performance of Glycated Hemoglobin Versus Oral Glucose Tolerance Test in the Diagnosis of Glycemic Disorders Among Women With Polycystic Ovary Syndrome in Southern Iraq

Background: Obese women with PCOS are at high risk for developing diabetes mellitus (T2DM). A baseline oral glucose tolerance test (2hrs-OGTT) annually is an important to screen for dysglycemia in women with PCOS particularly those with at least one risk factor. Due to its advantages by fasting is not required and less day-to-day variability during periods of stress or illness, glycated hemoglobin (HbA1c) might consider a convenient screening tool. This study aimed to evaluate the performance of HbA1c versus 2hrs-OGTT in the diagnosis of glycemic disorders in women with PCOS and to evaluate the correlation between glycemic disorders, insulin resistance (IR), and anthropometric measures. Patients and methods: One hundred and thirty women of a mean age 26.3 ± 6.85 year were diagnosed with PCOS according to Rotterdam 2003 criteria in Basrah, Southern Iraq. All women were examined for weight, BMI and waist circumference then they were sent for fasting plasma glucose (FPG), 2hrs-OGTT, HbA1c, and fasting insulin to assess IR. Results: By 2hrs-OGTT, impaired glucose tolerance and T2DM were diagnosed in 16.1% and 2.4% of women with PCOS respectively and 6.7% of lean women were prediabetes. HbA1c was underestimate the diagnosis of T2DM (0.8%) and overestimate prediabetes (20%) (p=0.011) and at HbA1c= 5.55%, the specificity was (74.3%) and sensitivity (56.5%) to discriminate normal from abnormal glucose status in women with PCOS (AUC: 0.645; 95% C.I.: 0.503–0.77; p = 0.03). One hundred women (76.9%) were either overweight or obese and most of them had IR (78%). Conclusion: screening of glycemic disorders is a crucial for PCOS by using 2hrs-OGTT regardless risk factor and HbA1c seems to be unsatisfactory screening tool to predict glycemic disorders in women with PCOS.