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https://hdl.handle.net/2440/140491
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Type: | Journal article |
Title: | Diagnostic accuracy of oral glucose tolerance tests, fasting plasma glucose and haemoglobin A1c for type 2 diabetes in women with polycystic ovary syndrome: A systematic review and meta-analysis |
Author: | Belsti, Y. Enticott, J. Azumah, R. Tay, C.T. Moran, L. Ma, R.C.W. Joham, A.E. Laven, J. Teede, H. Mousa, A. |
Citation: | Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 2024; 18(3):102970-1-102970-11 |
Publisher: | Elsevier |
Issue Date: | 2024 |
ISSN: | 1871-4021 1878-0334 |
Statement of Responsibility: | Yitayeh Belsti, Joanne Enticott, Rafiatu Azumah, Chau Thien Tay, Lisa Moran, Ronald C.W. Ma, Anju E. Joham, Joop Laven, Helena Teede, Aya Mousa |
Abstract: | Aims: To inform international guidelines, a systematic review and meta-analysis was conducted to assess the performance of diagnostic methods for type 2 diabetes in women with polycystic ovary syndrome (PCOS). Methods: An updated systematic search was conducted on five databases from 2017 until October 2023 and combined with prior searches (from inception). Meta-analyses of diagnostic accuracy tests were conducted. Results: Nine studies comprising 2628 women with PCOS were included. Against the oral glucose tolerance test, a haemoglobin A1C (HbA1c) ≥ 6.5% had a pooled sensitivity of 50.00% (95% confidence interval (CI): 35.53–64.47), specificity of 99.86% (95%CI: 99.49–99.98), and positive and negative predictive values of 92.59% (95%CI: 75.27–98.09) and 98.27% (95%CI: 97.73–98.68), respectively, with an accuracy of 98.17% (95%CI: 97.34–98.79). Fasting plasma glucose values ≥ 7.0 mmol/L had a pooled sensitivity of 58.14% (95%CI: 42.13–72.99), specificity of 92.59% (95%CI: 75.35–98.08), positive and negative predictive values of 92.59% (95%CI: 75.35–98.08) and 99.09% (95%CI: 98.71–99.36), respectively, and an accuracy of 99.00% (95%CI: 98.46–99.39) against the oral glucose tolerance test. Conclusions: To our knowledge, this is the first systematic review assessing the performance of diagnostic methods for type 2 diabetes in women with PCOS. We demonstrate that using a cut-off for HbA1c of ≥6.5% in this population may result in misdiagnosis of half of the women with type 2 diabetes. Our results directly informed the recommendations of the 2023 International PCOS Guideline, suggesting that the oral glucose tolerance test is the optimal method for screening and diagnosing type 2 diabetes in women with PCOS and is superior to fasting plasma glucose and HbA1c. |
Keywords: | Diagnostic accuracy Fasting glucose Glycated haemoglobin A1c Oral glucose tolerance test Polycystic ovary syndrome Screening Sensitivity Specificity Type 2 diabetes |
Description: | Available online 28 February 2024 |
Rights: | © 2024 The Authors. Published by Elsevier Ltd on behalf of Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
DOI: | 10.1016/j.dsx.2024.102970 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1016/j.dsx.2024.102970 |
Appears in Collections: | Research Outputs |
Files in This Item:
File | Description | Size | Format | |
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hdl_140491.pdf | Published version | 3.48 MB | Adobe PDF | View/Open |
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