Women with polycystic ovary syndrome are at a higher risk for developing type 2 diabetes compared with women without PCOS, regardless of BMI and age, according to findings published in Diabetes Care.
Anju E. Joham
“Much of the existing literature uses small cross-sectional populations, with participants recruited from clinic-based populations,” Anju E. Joham, PhD, MBBS, FRACP, a NHMRC Early Career Fellow at the Monash Centre for Health Research and Implementation at Monash University in Australia, told Endocrine Today. “This research is important as it informs us regarding the true risk of developing type 2 diabetes in a large community-based cohort of young women using longitudinal data over 15 years.”
Using data from the Australian Longitudinal Study on Women’s Health from 2000 to 2015, Joham and colleagues examined the incidence rates of type 2 diabetes among 8,378 Australian women aged 18 to 42 years. PCOS, type 2 diabetes, BMI and other factors were self-reported every 3 years via a mailed questionnaire.
In the total cohort, 186 women (mean age, 24.65 years) developed type 2 diabetes during a mean follow-up of 15 years compared with 8,192 who did not (mean age, 24.59 years). Women with PCOS made up a higher percentage of those who developed type 2 diabetes (27.42%) compared with those who did not (8.01%; P < .001). In addition, the type 2 diabetes incidence rate for women in the PCOS group was higher (4.19 per 1,000 person-years; 95% CI, 3.18-5.51) compared with women without PCOS (1.02 per 1,000 person-years; 95% CI, 0.86-1.2). The researchers further noted that type 2 diabetes risk increased 3.23-fold (95% CI, 2.07-5.05) in women with PCOS when adjusted for BMI, education, family history of type 2 diabetes, ethnicity and PCOS.
The researchers also noted that women with overweight or obesity or who had a family history of type 2 diabetes made up a greater percentage of the group with type 2 diabetes than they did in the group without (P < .001). Incidence rates for type 2 diabetes increased in parallel with BMI in women with PCOS, with a rate of 8.8 per 1,000 person-years in women with obesity (95% CI, 5.21-14.86), a rate of 4.67 per 1,000 person-years in women with overweight (95% CI, 2.51-8.68) and a rate of 3.21 per 1,000 person-years in women with healthy weight (95% CI, 2.07-4.98). Despite this, the researchers reported that women with PCOS and healthy weight had the highest incidence rate ratio (IRR) for type 2 diabetes (IRR = 4.68; 95% CI, 2.66-7.91) compared with women with overweight (IRR = 3.52; 95% CI, 1.5-7.69) and women with obesity (IRR = 2.36; 95% CI, 1.12-4.79).
“This paper has directly informed the diabetes screening recommendations in women with PCOS in the 2018 International Evidence-Based Guideline for the Assessment and Management of PCOS,” Joham said. “The guideline suggests that diabetes screening should be completed in all women with PCOS. Following initial assessment, testing should be repeated every 1 to 3 years, across all BMI categories, based on individual patient characteristics and the presence of other diabetes risk factors.” – by Phil Neuffer
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Anju E. Joham, PhD, MBBS, FRACP, can be reached at firstname.lastname@example.org.
Disclosures: The authors report no relevant financial disclosures.