TY  - JOUR
A1  - Moehlig, M.
A1  - Floeter, A.
A1  - Spranger, Joachim
A1  - Weickert, Martin O.
A1  - Schill, T.
A1  - Schloesser, H. W.
A1  - Brabant, G.
A1  - Pfeiffer, Andreas F. H.
A1  - Selbig, Joachim
A1  - Schoefl, C.
T1  - Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling
JF  - Diabetologia : journal of the European Association for the Study of Diabetes (EASD)
N2  - Aims/hypothesis Polycystic ovary syndrome (PCOS) is a risk factor of type 2 diabetes. Screening for impaired glucose metabolism (IGM) with an OGTT has been recommended, but this is relatively time-consuming and inconvenient. Thus, a strategy that could minimise the need for an OGTT would be beneficial. Materials and methods Consecutive PCOS patients (n=118) with fasting glucose < 6.1 mmol/l were included in the study. Parameters derived from medical history, clinical examination and fasting blood samples were assessed by decision tree modelling for their ability to discriminate women with IGM (2-h OGTT value >= 7.8 mmol/l) from those with NGT. Results According to the OGTT results, 93 PCOS women had NGT and 25 had IGM. The best decision tree consisted of HOMA-IR, the proinsulin:insulin ratio, proinsulin, 17-OH progesterone and the ratio of luteinising hormone:follicle-stimulating hormone. This tree identified 69 women with NGT. The remaining 49 women included all women with IGM (100% sensitivity, 74% specificity to detect IGM). Pruning this tree to three levels still identified 53 women with NGT (100% sensitivity, 57% specificity to detect IGM). Restricting the data matrix used for tree modelling to medical history and clinical parameters produced a tree using BMI, waist circumference and WHR. Pruning this tree to two levels separated 27 women with NGT (100% sensitivity, 29% specificity to detect IGM). The validity of both trees was tested by a leave-10%-out cross-validation. Conclusions/interpretation Decision trees are useful tools for separating PCOS women with NGT from those with IGM. They can be used for stratifying the metabolic screening of PCOS women, whereby the number of OGTTs can be markedly reduced.
KW  - decision tree
KW  - HOMA
KW  - impaired glucose tolerance
KW  - insulin
KW  - insulin resistance
KW  - polycystic ovary syndrome
KW  - proinsulin
KW  - type 2 diabetes mellitus
Y1  - 2006
U6  - https://doi.org/10.1007/s00125-006-0395-0
SN  - 0012-186X
VL  - 49
SP  - 2572
EP  - 2579
PB  - Springer
CY  - Berlin
ER  -