SAN FRANCISCO -- Sisters and mothers of women with polycystic ovary syndrome may have high androgen levels and insulin resistance that puts them at risk for type 2 diabetes and cardiovascular disease, even if they appear unaffected clinically.
That conclusion emerged from two studies presented at the annual meeting of the Endocrine Society.
"Our results suggest that this group should be screened for a high risk of diabetes, although screening and long-term follow-up should be validated in further studies," said Dr. Bulent O. Yildiz, an investigator in one of the studies. He and his associates measured glucose tolerance and androgen levels in 102 first-degree relatives of 52 patients with polycystic ovary syndrome (PCOS). Eighty-two matched controls were also evaluated.
Of the 37 mothers who were studied, 10% had diabetes and 26% had impaired glucose tolerance to a 2-hour glucose tolerance test. Only 1 of 19 sisters had impaired glucose tolerance, even though 3 had previously been diagnosed with PCOS.
Compared with the controls, however, the female relatives had higher androgen levels, and those who had normal glucose tolerance had higher insulin levels, suggestive of some insulin resistance, said Dr. Yildiz of the University of California, Los Angeles.
Mean testosterone levels were higher in the mothers (90 ng/dL vs. 41 ng/dL) and sisters (113 ng/dL vs. 64 ng/dL) than in controls. The mothers and sisters both had significantly higher fasting-insulin levels and lower fasting glucose to insulin ratios.
The second study showed that about half of the sisters of PCOS patients who actually have polycystic ovaries--and high testosterone and insulin levels--have neither hirsutism nor are oligomenorrheic or amenorrheic.
The researchers used ultrasound to determine whether 134 PCOS patients had polycystic ovaries. They then compared testosterone and insulin levels of the sisters with PCOS with those of sisters who did not have the disorder, said Dr. Stephen Franks of Middlesex Hospital, London.
The 133 sisters with polycystic ovaries had serum testosterone and fasting-insulin levels similar to those of their PCOS sisters. In 49 unaffected sisters, those levels were lower and similar to those of matched unaffected controls. That finding is reassuring because it says that the measures often used to indicate PCOS are indeed reliable, he said.
But the signs were not often present in the affected sisters. Of the 111 PCOS subjects who had affected sisters, 64 had hirsutism, 97 were oligomenorrheic or amenorrheic, and 50 were both. All the subjects had at least one of these signs.
Of the 133 affected sisters, 52 had hirsutism, 42 were oligomenorrheic or amenorrheic, and 25 were both. But 64 of the affected sisters were neither oligomenorrheic and/or amenorrheic nor hirsute. The study supports the notion that hyperandrogenism and hyperinsulinemia are inherited traits in families with PCOS but that those features may be limited to those female members who have polycystic ovaries.
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group
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Screen PCOS patients' sisters, mothers for diabetes 
