Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2022; 13(3): 240-250
Published online Mar 15, 2022. doi: 10.4239/wjd.v13.i3.240
Higher risk of type 2 diabetes in young women with polycystic ovary syndrome: A 10-year retrospective cohort study
Wan-Ting Liao, Jing-Yang Huang, Ming-Tsung Lee, Yu-Cih Yang, Chun-Chi Wu
Wan-Ting Liao, Chun-Chi Wu, Institute of Medicine, Chung-Shan Medical University, Taichung 402, Taiwan
Wan-Ting Liao, Chinese Medicine Department, Show Chwan Memorial Hospital, Changhua 500, Taiwan
Jing-Yang Huang, Research Center for Health Data Science, Chung Shan Medical University Hospital, Taichung 402, Taiwan
Ming-Tsung Lee, National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632, Taiwan
Yu-Cih Yang, Clinical Trial Research Center, China Medical University Hospital, Taichung 404, Taiwan
Author contributions: Liao WT and Wu CC contributed to the conceptualization, writing-review and editing; Huang JY, Lee MT and Yang YC contributed to the methodology; Yang YC contributed to the software and formal analysis; Liao WT and Lee MT contributed to the validation; Huang JY contributed to the data curation; Liao WT contributed to the writing-original draft preparation; Wu CC contributed to the supervision and project administration; all authors reviewed the final version of the manuscript.
Supported by the Show Chwan Memorial Hospital, No. SRD-108014.
Institutional review board statement: This study was approved by the institutional review board of China Medical University in central Taiwan (CMUH104-REC2-115).
Informed consent statement: The informed consent form is waived by the Institutional Review Board.
Conflict-of-interest statement: The authors declare no conflict-of-interest.
Data sharing statement: Restrictions apply to the availability of some or all data generated or analyzed during this study to preserve patient confidentiality and because they were used under license. Upon request, the corresponding author will provide details on the restrictions and conditions under which access to some data may be provided.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Chi Wu, PhD, Associate Professor, Institute of Medicine, Chung-Shan Medical University, 110 Section 1 Jianguo North Road, Taichung 402, Taiwan. daniel@csmu.edu.tw
Received: August 12, 2021
Peer-review started: August 12, 2021
First decision: October 3, 2021
Revised: October 13, 2021
Accepted: February 19, 2022
Article in press: February 19, 2022
Published online: March 15, 2022
Abstract
BACKGROUND

Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age. Over the last few decades, research studies have revealed that PCOS is strongly associated with metabolic disorders, including metabolic syndrome, obesity, insulin resistance and prediabetes. Clinical observation has shown that women with PCOS are expected to have an increased risk of developing type 2 diabetes (T2DM) in the future.

AIM

To assess the hazard ratio (HR) of T2DM between women with/without PCOS.

METHODS

This population-based, retrospective cohort study evaluated data retrieved from the National Health Insurance Research Database. The subjects were women with PCOS (n = 2545) identified on the basis of diagnosis, testing, or treatment codes, and women without PCOS as controls (n = 2545). The HR of T2DM between women with or without PCOS was the main outcome measure analyzed.

RESULTS

Our study found that, during a 10-year follow-up period, the overall incidence of T2DM was 6.25 per 1000 person-years in the PCOS group compared with 1.49 in the control group. After adjustment for potential confounding variables, the overall incidence of T2DM was higher in the PCOS group vs the control group (HR = 5.13, 95%CI: 3.51-7.48, P < 0.0001). The risk of developing T2DM subsequent to PCOS decreased with increasing diagnosis age: the adjusted HR was 10.4 in the 18–24-year age group, 5.28 in the 25-29-year age group, and 4.06 in the 29-34-year age group. However, no such significant association was noted in women older than 35 years.

CONCLUSION

These findings highlight the importance of prompting a more aggressive treatment to prevent diabetes in women diagnosed with PCOS at a young age, and, in contrast, the lessened importance of this type of intervention in women diagnosed with PCOS at a late reproductive age.

Keywords: Polycystic ovary syndrome, Diabetes, Incidence, Hazard ratio, Population-based cohort study

Core Tip: We aimed to evaluate the incidence of type 2 diabetes (T2DM) over time in women with polycystic ovary syndrome (PCOS) at different diagnosis ages, in comparison with non-PCOS controls. Our results showed that, among women diagnosed with PCOS at a young age, the incidence of T2DM was significantly higher than that of age-matched women in the general population. However, the risk disappeared among women diagnosed with PCOS after age 35. These findings highlight the importance of prompting a more aggressive treatment to prevent diabetes among women diagnosed with PCOS at a young age, and, in contrast, the lessened importance of this type of intervention in women diagnosed with PCOS at a late reproductive age.