Rubin KH, et al. J Clin Endocrinol Metab. 2017;doi:10.1210/jc.2017-01354.

August 31, 2017

Women with polycystic ovary syndrome are four times more likely to develop type 2 diabetes compared with women without the syndrome, and the increased risk may be associated with BMI, insulin and glucose levels, according to a study of women in Denmark.

“Many women with PCOS are obese, but the risk for the development of diabetes in PCOS is unknown,” Dorte Glintborg, MD, PhD, of the department of endocrinology at Odense University Hospital, said in a press release. “In this study, we found that the risk of developing diabetes is four times greater and that diabetes is diagnosed 4 years earlier in women with PCOS compared to controls.”

Glintborg and colleagues evaluated data on women with PCOS from the National Patient Register (PCOS Denmark; n = 18,477) including a subgroup of women with PCOS examined at Odense University Hospital, as well as three age-matched controls per participant (n = 54,680). Researchers sought to determine the risk for development of type 2 diabetes in women with PCOS and whether age, number of births and prescriptions for oral contraceptives modify the effects. Median follow-up was 11.1 years.

Participants in PCOS Denmark were more likely to develop type 2 diabetes than controls (HR = 4; 95% CI, 3.7-4.3), and the risk remained elevated when gestational diabetes was excluded from analysis (HR = 3.5; 95% CI, 3.2-3.8).

Prescriptions for oral contraceptives were associated with a higher risk for type 2 diabetes (HR = 1.4; 95% CI, 1.3-1.6); however, oral contraceptives were not associated with type 2 diabetes when gestational diabetes was excluded from the analysis. The risk for type 2 diabetes was decreased with higher numbers of births.

Participants in PCOS Denmark were younger than controls at type 2 diabetes diagnosis (median age, 31 years vs. 35 years; P < .001); similarly, more participants were younger than 40 years in PCOS Denmark compared with controls (82% vs. 66%; P < .001).

Compared with controls who developed type 2 diabetes, participants in PCOS Denmark who developed diabetes had a lower prevalence of oral contraceptive prescriptions, higher prevalence of metformin prescriptions and a lower number of births.

BMI, HbA1c, fasting blood glucose, 2-hour blood glucose, homeostasis model assessment of insulin resistance and triglyceride values were positively associated with type 2 diabetes development in multiple regression analyses.

“The increased risk of developing [type 2 diabetes] in PCOS is an important finding,” Glintborg said. “Diabetes may develop at a young age, and screening for diabetes is important, especially in women who are obese and have PCOS.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.