The role of obstetrician-gynecologists and reproductive endocrinologists in the blood glucose management of polycystic ovary syndrome

Abstract

Background: This study aimed to compare the differences between reproductive endocrinologists (Repro-Endo) and obstetricians-gynecologists (Ob-Gyn; non-reproductive medicine specialty) in diagnosing, evaluating, and treating PCOS women with insulin resistance (IR).

Methods: Repro-Endo and Ob-Gyn in China participated in this survey, and their responses were analyzed using χ² tests, Fisher exact tests, and multivariable logistic regression analysis.

Results: The study analyzed 2412 survey responses (92.3% OB-Gyn; 98.5% women). Physician’s age, hospital grade, specialty, and the number of PCOS patients who visit the physicians, revealed that Repro-Endo participants were more likely to suggest an oral glucose tolerance test (OR, 1.727; 95% CI, 1.272–2.345) as their first choice than Ob-Gyn participants. The most common treatments for patients with PCOS were lifestyle modification (>95%) and metformin use (>80%). More Repro-Endo participants prescribed metformin at a dose of 1.5 g/day compared with OB-Gyn (46.5% vs. 23.5%), and more OB-Gyn participants reported being unclear about the appropriate dosage of metformin for patients with obesity and PCOS (12.5% vs. 1.6%).

Conclusion: This survey identified knowledge gaps in metabolic screening for patients with IR and PCOS. Similarly, it highlights the need to improve IR management education for physicians caring for PCOS women.

摘要

背景

本研究旨在比较生殖内分泌医生(ReproEndo)和妇产科医生(Ob-gyn；非生殖医学专业)在诊断、评估和治疗多囊卵巢综合征(PCOS)患者胰岛素抵抗(IR)方面的差异。

方法

中国的生殖内分泌和妇产科医生参与问卷调查, 对他们的回答采用χ-2检验、FISHER精确检验和多因素Logistic回归进行分析。

结果

这项研究分析了2412份调查回复(92.3%为妇产科医生；98.5%为女性)。医生的年龄、医院级别、接诊的PCOS患者的数量, 生殖内分泌医生比妇产科医生更有可能首选口服葡萄糖耐量试验(OR, 1.727；95%CI, 1.272-2.345)。PCOS患者最常见的治疗方式是改变生活方式(>95%)和二甲双胍(>80%)。与妇产科医生相比, 更多的生殖内分泌医生每天开具1.5g剂量的二甲双胍(46.5% VS 23.5%)处方, 更多的妇产科医生报告不清楚针对肥胖症和PCOS患者二甲双胍的合适剂量(12.5% VS 1.6%)。

结论

这项调查确定了在IR和PCOS患者的代谢筛查方面的知识差距。同样, 强调了医生对PCOS女性IR的管理教育需要提升。

缩写

T2 DM：2型糖尿病；PCOS：多囊卵巢综合征；IR：胰岛素抵抗；IGT：糖耐量受损；OGTT：口服糖耐量试验；HOMA-IR：胰岛素抵抗稳态模型；ReproEndo：生殖内分泌科；OB-Gyn：妇产科；GLP-1 receptor agonist：胰高血糖素样肽-1受体激动剂

关键词:

• 胰岛素抵抗
• 多囊卵巢综合征
• 口服糖耐量试验
• 二甲双胍

Keywords:

• Insulin resistant
• polycystic ovary syndrome
• oral glucose tolerance test
• metformin

Acknowledgments

The authors would like to thank all Chinese obstetricians and gynaecologists who participated in the survey for sharing their valuable views. We also thank China Maternal and Child Health Association for supporting our survey. We thank Editage (www.editage.cn) for English language editing.

Authors’ contributions

YW and AJS conceptualized the research topic. RLM and AJS designed the questionnaire. WW, QMZ, YF, YZ, HD, ZYT, XQZ, YQZ, YD, and YFW provided valuable comments and suggestions on the questionnaire revision and played a critical role in the distribution, completion, and collection of questionnaires. YW RLM, WW, YZ, and AJS analyzed and interpreted the data. YW, YD, and YFW guided the statistical analysis. YW was a major contributor in writing the manuscript. AJS, RLM, and YZ were responsible for revision. All authors read and approved the final manuscript.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (No. S-K1373). Written informed consent was obtained from all participants before the online survey.

Consent for publication

Not applicable.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Capital’s Funds for Health Improvement and Research (CFH: 2020-2-40113) and the Natural Science Foundation of China (No. 82074143).