The risk of developing type 2 diabetes (T2D) is higher in women with polycystic ovary syndrome (PCOS), and they are also diagnosed at an earlier age compared with women without PCOS, according to results published in The Journal of Clinical Endocrinology & Metabolism. This is the first nationwide study to demonstrate a connection between T2D and PCOS.
“Many women with PCOS are obese, but the risk for the development of diabetes in PCOS is unknown,” said one of the study’s authors, Dorte Glintborg, MD, PhD, Odense University Hospital, Denmark. “In this study, we found that the risk of developing diabetes is four times greater and that diabetes is diagnosed four years earlier in women with PCOS compared to controls."
According to data from the Hormone Health Network, roughly 5 to 6 million women in the United States have PCOS, and it is one of the most common endocrine conditions in women of childbearing age.
Dr. Glintborg and colleagues conducted this national register-based study to assess the risk of developing T2D in women with PCOS. They included patients with PCOS (PCOS Denmark and embedded cohort, PCOS OUH) and a control population without any previous diagnosis of T2D. The PCOS OUH patients (n=1,162) included premenopausal women with PCOS and upon standardized clinical and biochemical exam. PCOS Denmark (n=18,477) included women with PCOS from the Danish National Patient Register. In addition, three age-matched controls were included per patient (n=54,680).
After a median follow-up of 11.1 years, researchers found that the HR for developing T2D in PCOS Denmark was 4.0 (95% CI: 3.7, 4.3; P < 0.001), with a total event rate of T2D of 8.0 per 1,000 patient years, compared with 2.0 per 1,000 patient years in the control group (P < 0.001).
In PCOS Denmark, median age at T2D diagnosis was 31 years, compared with 35 years in the control group (P < 0.001). Upon multiple regression analysis, researchers found the following factors to be positively associated with the development of T2D: BMI, HbA1c, fasting blood glucose, 2-hour blood glucose, homeostasis model assessment of insulin resistance, and triglycerides. A higher number of births was negatively associated with T2D development.
“The increased risk of developing T2D in PCOS is an important finding. Diabetes may develop at a young age and screening for diabetes is important, especially in women who are obese and have PCOS,” concluded Dr. Glintborg.