Comparing the pre-gestational metabolic states of policystic ovary syndrome patients who has gestational diabetes mellitus

Objective: We aimed to compare the pre-gestational metabolic states of the women who were previously diagnosed with PCOS and had GDM in the subsequent pregnancy and who did not have GDM in subsequent pregnancy and to determine the independent variables that predict the GDM risk for PCOS patients in the subsequent pregnancy. Patients and methods: Between the dates 2007 and 2012, the patients who were diagnosed with PCOS in our outpatient gynecology and infertility clinic were searched retrospectively. Then these patients ewre called for pregnancy states. The pregnancy outcome of patients who achieved pregnancy but did not come for pregnancy visits in our clinic were accessed by phone. The patients? pre-gestational mean age, BMI, metabolic and hormonal profiles and pregnancy outcomes were compared between PCOS cases who developed GDM or not. In statistical methods, chi-square test, Mann-Whitney-U test and the Wilcoxon test were used. Results: We found some differences in pregestational metabolic states between the PCOS patients who developed GDM in pregnancy or not. The mean age, BMI, VLDL, triglyceride, fasting insulin, fasting c-peptide levels, 1st and 2nd hour glucose levels in 75 gr OGTT, HOMA-IR measures and neonates? birth weights were higher in GDM group than non-GDM group. But HDL was lower in GDM group than non- GDM group. There were no differences between the mean levels CRP, hormonal profile, mean fasting glucose, LDL cholesterol, total cholesterol levels and mode of delivery. Glucose intolerance was significantly higher in theGDM group (%74,07 vs %6,66). With the multipl logistic regression analysis we found the BMI as the strongest independent predictor of GDM in PCOS patients (OR: 2,831, %95 CI: 1,234-6,495). The second independent predictor was the high 2. hour glucose level in OGTT (OR: 1,119, %95 CI: 1,026-1,221) Conclusion: The pre-gestational metabolic variables including the age, BMI, lipid profile, and glucose metabolism are significantly different in the GDM group than the non-GDM group. The obesity and glucose intolerance are the independent predictors of GDM in PCOS cases. Key words: Polycystic ovarian syndrome, Gestational diabetes mellitus, glucose intolerance, insulin resistance, obesity