Nadira S Kakoly1, Arul Earnest1, Helena J Teede1,2,3, Lisa J Moran1, Anju E Joham4,2. 1. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia. 2. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia. 3. Monash Partners Academic Health Science Centre, Melbourne, Victoria, Australia. 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia anju.joham@monash.edu.
Abstract
OBJECTIVE: The nature of the independent relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes remains unclear. Few studies have aimed to clarify this relationship independent of obesity in longitudinal population-based cohorts. RESEARCH DESIGN AND METHODS: We used the Australian Longitudinal Study on Women's Health (ALSWH) (2000-2015) database to estimate nationwide incidence rates and predictors of type 2 diabetes among women aged 18-42 using person-time and survival analysis. RESULTS: Over a follow-up of 1,919 person-years (PYs), 186 women developed type 2 diabetes. The incidence rate was 4.19/1,000 PYs and 1.02/1,000 PYs (P < 0.001) in PCOS and control subjects. On subgroup analyses across healthy-weight, overweight, and obese categories of women, the incidence rates for type 2 diabetes were 3.21, 4.67, and 8.80, whereas incidence rate ratios were 4.68, 3.52, and 2.36 (P < 0.005) in PCOS versus age-matched control subjects. PCOS was one of the most influential predictors for type 2 diabetes in the entire cohort (hazard ratio 3.23, 95% CI 2.07-5.05, P < 0.001) adjusting for BMI, education, area of residence, and family history of type 2 diabetes. CONCLUSIONS: Women with PCOS are at an increased risk of type 2 diabetes, irrespective of age and BMI. The incidence of type 2 diabetes increases substantially with increasing obesity; yet, PCOS adds a greater relative risk in lean women. Based on the overall moderate absolute clinical risk demonstrated here, guideline recommendations suggest type 2 diabetes screening every 1-3 years in all women with PCOS, across BMI categories and age ranges, with frequency influenced by additional type 2 diabetes risk factors.
OBJECTIVE: The nature of the independent relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes remains unclear. Few studies have aimed to clarify this relationship independent of obesity in longitudinal population-based cohorts. RESEARCH DESIGN AND METHODS: We used the Australian Longitudinal Study on Women's Health (ALSWH) (2000-2015) database to estimate nationwide incidence rates and predictors of type 2 diabetes among women aged 18-42 using person-time and survival analysis. RESULTS: Over a follow-up of 1,919 person-years (PYs), 186 women developed type 2 diabetes. The incidence rate was 4.19/1,000 PYs and 1.02/1,000 PYs (P < 0.001) in PCOS and control subjects. On subgroup analyses across healthy-weight, overweight, and obese categories of women, the incidence rates for type 2 diabetes were 3.21, 4.67, and 8.80, whereas incidence rate ratios were 4.68, 3.52, and 2.36 (P < 0.005) in PCOS versus age-matched control subjects. PCOS was one of the most influential predictors for type 2 diabetes in the entire cohort (hazard ratio 3.23, 95% CI 2.07-5.05, P < 0.001) adjusting for BMI, education, area of residence, and family history of type 2 diabetes. CONCLUSIONS:Women with PCOS are at an increased risk of type 2 diabetes, irrespective of age and BMI. The incidence of type 2 diabetes increases substantially with increasing obesity; yet, PCOS adds a greater relative risk in lean women. Based on the overall moderate absolute clinical risk demonstrated here, guideline recommendations suggest type 2 diabetes screening every 1-3 years in all women with PCOS, across BMI categories and age ranges, with frequency influenced by additional type 2 diabetes risk factors.
Authors: Panagiotis Anagnostis; Rodis D Paparodis; Julia K Bosdou; Christina Bothou; Djuro Macut; Dimitrios G Goulis; Sarantis Livadas Journal: Endocrine Date: 2021-06-26 Impact factor: 3.633
Authors: Julia Hudnut-Beumler; Jill L Kaar; Anya Taylor; Megan M Kelsey; Kristen J Nadeau; Philip Zeitler; Janet Snell-Bergeon; Laura Pyle; Melanie Cree-Green Journal: Pediatr Diabetes Date: 2021-04-27 Impact factor: 3.409