Polycystic ovary syndrome is a risk factor for diabetes and prediabetes in middle-aged but not elderly women: a long-term population-based follow-up study

Abstract

Objective: To study the incidence rate and hazard ratios of diabetes and prediabetes between women with PCOS and healthy subjects.

Design: Prospective population-based study.

Setting: Not applicable.

Patient(s): Women with PCOS (n = 178) and eumenorrheic, nonhirsute, healthy women as controls (n = 1,524), all followed for a median time of 12.9 years.

Intervention(s): None.

Main outcome measure(s): Incidence rate and hazard ratios of diabetes and prediabetes between women with PCOS and healthy controls.

Result(s): We analyzed the participants on two pathways. First, for detecting new diabetes mellitus (DM) events, we selected participants who were free of DM at baseline (n = 39). Second, for detecting new pre-DM events, we selected participants who were free of pre-DM and DM at baseline (n = 222) from the baseline population. The rest of the population were included for final analysis to calculate the incidence rates and hazard ratio of diabetes and prediabetes events. The incidence rates of diabetes were 12.9 and 4.9 per 1,000 person-years for PCOS and controls, respectively. This incidence rate in women younger than 40 with and without PCOS was 13.4 and 4.2, respectively. The adjusted hazard ratio (HR) for women ≤40 was 4.9 (95% confidence interval [CI], 2.5-9.3). There were no statistically significant differences between the two groups studied after age 40. The incidence rates of prediabetes were 29.7 and 25.9 per 1,000 person-years for PCOS and healthy women, respectively. The incidence rate in women younger than 40 with and without PCOS was 30.3 and 23.9, respectively. The adjusted HR for women ≤40 years, 1.7 (95% CI, 1.1-2.6), disappeared after age 40.

Conclusion(s): These data suggest that routine screening for diabetes in prevention strategies does not need to be emphasized for PCOS patients at late reproductive ages if they have not been affected by glucose intolerance up to that point.

Keywords: Diabetes; PCOS; incidence; population-based cohort study; prediabetes.