A 26-year-old obese woman with oligomenorrhea has Rotterdam criteria-confirmed PCOS. She is not seeking conception. Which combination of investigations is recommended for metabolic screening according to international guidelines?

• A Fasting glucose and lipid profile only
• B Oral glucose tolerance test and lipid profile ✓
• C HbA1c and thyroid function tests
• D Fasting insulin and lipid profile

Explanation

International PCOS guidelines recommend OGTT (75g) for all women with PCOS and overweight/obesity because fasting glucose misses many cases of impaired glucose tolerance and type 2 diabetes. Lipid profile is also recommended for metabolic risk assessment. HbA1c is less sensitive than OGTT. Fasting insulin is not routinely recommended for clinical practice.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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