In part 4 of this Exclusive Interview, Rhoda Cobin talks with Diabetes in Control Medical Editor Joy Pape about PCOS correlation with other testosterone and glycemic disorders in women.
Rhoda H. Cobin, MD, MACE is Clinical Professor of Medicine at the Ichan School of Medicine at Mount Sinai in New York.
Transcript of this video segment:
Pape: And that reminds me years ago — and you had taught me that really PCOS is insulin resistance in women.
Pape: Or metabolic syndrome in women.
Cobin: PCOS is a manifestation, yes.
Pape: Right. Because who’s to say when they went to do studies on family members, well, a lot of the fathers had died young, so there weren’t a lot that they could find out. And I know we’ve come a far way from that.
Pape: But it is just very interesting. And —
Cobin: Yes, exactly. So, men obviously aren’t going to have the same manifestations. They — to go backwards, how does PCOS manifest itself in women? So, the diagnosis is made by seeing irregular menstrual periods, signs of what we call hyperandrogenism. Androgens are chemicals that in women cause facial hair growth, acne, loss of scalp hair, irregular periods, and when they’re present in great excess– usually not in PCOS, but in great excess they can cause deepening of the voice or thicker, stronger muscles, and some other physical changes in women’s genitalia. That being said, those are markers and those are definitely issues that need to be addressed; irregular periods, infertility, cosmetic problems. But yes, if you say, well, those things that are physical markers also indicate that this woman may have metabolic disorders. And it turns out that in large studies, and this is again an ongoing process, in large studies most of them relate the degree of hyperandrogenism. And in this case, the measurement of testosterone in a woman. And testosterone is a normal hormone in women. It’s just much, much higher in men. But the higher the testosterone in women, the more likely they are to have metabolic syndrome. So, again, it depends on how you define PCOS and what population you’re looking at. It also depends to some degree on where you’re studying these women because it makes the difference in their ethnicity, how old they are, their family history, and so on. But a good clue is the higher the testosterone, the more likely they are to have metabolic syndrome and its consequences.
Pape: So, how common are dysglycemic disorders in PCOS?
Cobin: Again, depends on age, location, ethnicity, et cetera. But a good rough figure would be 30% or 40% probably and probably goes up with age. If you look at impaired fasting glucose, impaired glucose tolerance, you see that even in adolescence. And again, if they’re obese that increases the risk. And then in studies that have looked over time, the progression of people who have abnormal glucose tolerances to full blown diabetes is somewhere around 3% to 5%, to even 15% in some studies, per year. So, if you’re following these people year to year to year, they’re going to progress as they get older as well.