One‐Hour Plasma Glucose and Early Cardiometabolic Risk in Normoglycaemic Women With Polycystic Ovary Syndrome: A Retrospective Cross‐Sectional Study

ABSTRACT Objective To determine whether elevated 1‐h plasma glucose (1hPG) during oral glucose tolerance testing is associated with the cross‐sectional presence of cardiometabolic risk factors (CMRFs) in normoglycaemic women with polycystic ovary syndrome (PCOS). Design Retrospective cross‐sectional study. Setting Single‐centre. Population A total of 1152 reproductive‐age PCOS women with normal fasting (FPG < 5.6 mmol/L) and 2‐h glucose (2hPG < 7.8 mmol/L). Methods Participants were stratified by 1hPG as normal (< 8.6 mmol/L) or elevated (≥ 8.6 mmol/L). Prespecified CMRFs (overweight, central obesity, hypertension and dyslipidaemia) were assessed. Associations were examined using univariable and age‐adjusted multivariable logistic regression. Main Outcome Measures Association between elevated 1hPG and the presence of ≥ 1 CMRF as well as individual CMRFs. Results Elevated 1hPG was present in 257/1152 (22.3%) women and was associated with higher prevalences of overweight, central obesity, and dyslipidaemia, but not hypertension. Elevated 1hPG was associated with ≥ 1 CMRF in both crude (OR 2.05, 95% CI 1.44–2.91) and age‐adjusted analyses (aOR 1.91, 95% CI 1.34–2.73; both p < 0.001). Age‐adjusted associations persisted for overweight, central obesity, and dyslipidaemia, but not hypertension. Discrimination for the cross‐sectional presence of ≥ 1 CMRF was limited, whereas sensitivity was 25.4% and specificity 85.8% at the prespecified threshold of 8.6 mmol/L. Conclusions Among normoglycaemic women with PCOS, elevated 1hPG was associated with a less favourable cardiometabolic profile and a higher cross‐sectional cardiometabolic risk burden. 1hPG may serve as an adjunct marker within routine OGTT interpretation for early cardiometabolic risk enrichment, but prospective validation is needed.