Published online Mar 15, 2022. doi: 10.4239/wjd.v13.i3.240
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
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. Research over the last few decades has revealed that PCOS is strongly associated with metabolic disorders. Even at a young age, women with PCOS also exhibit β-cell dysfunction, impaired glucose tolerance, and type 2 diabetes (T2DM).
Although current evidence supports the contention that diabetes is much more prevalent in women with PCOS than it is in the general population. The majority of longitudinal studies regarding the incidence of T2DM in women with PCOS are from non-Asian countries.
We aimed to evaluate the incidence of T2DM over time in women with PCOS at different diagnosis ages, in comparison with non-PCOS controls.
The data retrieved from the Longitudinal Health Insurance Database 2000 (LHID2000). LHID2000 is a subset of the National Health Insurance Research Database (NHIRD) that contains the entire original claim data of 1000000 individuals randomly sampled from the 2000 registry for beneficiaries (ID) of the NHIRD, which maintains the registration data of everyone who was a beneficiary of the National Health Insurance program.
After adjustment for potential confounding variables (age, comorbidities and medications), the overall incidence of T2DM was higher in the PCOS group compared with 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. After age 35, the association between PCOS and T2DM was not statistically significant.
The risk of developing T2DM subsequent to PCOS decreased with increasing diagnosis age. No such significant association was noted in women older than 35 years.
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.