Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Ollila, Meri‐Maija; West, S.; Keinänen‐Kiukaanniemi, Sirkka; Jokelainen, Jari; Auvinen, Juha; Puukka, Katri; Ruokonen, Aimo; Järvelin, Marjo‐Riitta; Tapanainen, Juha S.; Franks, Stephen; Piltonen, Terhi; Morin‐Papunen, Laure

doi:10.1093/humrep/dew329

Cited by 131 publications

(80 citation statements)

References 33 publications

(57 reference statements)

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“…In the present study, PCOS women without GDM were significantly leaner than women with GDM, and their mean BMI was similar to the BMI of the controls, which may explain the findings. This result is also in keeping with the findings of a recent large Finnish cohort study in which only overweight and obese women with PCOS were at risk for subsequent T2D ( 31 ). These results suggest that obese women with PCOS are at substantial risk for GDM and should, therefore, be recognised and counselled as a high-risk group before or during the early stages of pregnancy to achieve more efficient therapeutic interventions.…”

Section: Discussionsupporting

confidence: 90%

Polycystic ovary syndrome and risk factors for gestational diabetes

Mustaniemi

Vääräsmäki

Eriksson

et al. 2018

Endocrine Connections

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ObjectiveTo study the roles of self-reported symptoms and/or prior diagnosis of polycystic ovary syndrome (PCOS) and other potential risk factors for gestational diabetes mellitus (GDM) and to clarify whether the screening of GDM in early pregnancy is beneficial for all women with PCOS.DesignThe FinnGeDi multicentre case-control study including 1146 women with singleton pregnancies diagnosed with GDM and 1066 non-diabetic pregnant women. There were 174 women with PCOS (symptoms and/or diagnosis self-reported by a questionnaire) and 1767 women without PCOS (data missing for 271).MethodsThe study population (N = 1941) was divided into four subgroups: GDM + PCOS (N = 105), GDM + non-PCOS (N = 909), non-GDM + PCOS (N = 69), and controls (N = 858). The participants’ characteristics and their parents’ medical histories were compared.ResultsThe prevalence of PCOS was 10.4% among GDM women and 7.4% among non-diabetics (odds ratios (OR) 1.44, 95% CI: 1.05–1.97), but PCOS was not an independent risk for GDM after adjustments for participants’ age and pre-pregnancy BMI (OR 1.07, 95% CI: 0.74–1.54). In a multivariate logistic regression analysis, the most significant parameters associated with GDM were overweight, obesity, age ≥35 years, participant’s mother’s history of GDM, either parent’s history of type 2 diabetes (T2D) and participant’s own preterm birth.ConclusionsThe increased risk of GDM in women with PCOS was related to obesity and increased maternal age rather than to PCOS itself, suggesting that routine early screening of GDM in PCOS women without other risk factors should be reconsidered. Instead, family history of GDM/T2D and own preterm birth were independent risk factors for GDM.

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Section: Discussionsupporting

confidence: 90%

Polycystic ovary syndrome and risk factors for gestational diabetes

Mustaniemi

Vääräsmäki

Eriksson

et al. 2018

Endocrine Connections

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“…The results of our study confirm a high risk of abnormal glucose tolerance in overweight/obese women with diagnosed PCOS [ 51 ]. The recently published data from the multi-centre national population health examination survey (WOBASZ) revealed that the prevalence of IFG in the cohort of Polish women aged 20–34 years totals 4.3%, which is much lower than in our PCOS cohort (25.8%) [ 52 ].…”

Section: Discussionsupporting

confidence: 82%

Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

Jacewicz-Święcka

Kowalska

2020

JCM

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Data concerning metabolic consequences in women with polycystic ovary syndrome (PCOS) are delivered mainly by cross-sectional studies. In this research, we re-examined 31 Caucasian PCOS women after a median period of 120.9 months to evaluate the changes in metabolic syndrome components. Clinical examination, oral glucose tolerance test with estimations of glucose and insulin, lipids, sex hormone-binding globulin (SHBG) and sex hormones assessments were performed on two occasions. Additionally, the euglycaemic hyperinsulinaemic clamp technique was used at the baseline to assess insulin sensitivity (M-clamp value). In the end, the median age of participants was 35. We observed an increase in glucose concentrations, a decrease in insulin concentrations and no changes in insulin resistance markers. Final mean glucose, mean insulin, Matsuda index and body mass index (BMI) were correlated with baseline M-clamp value and SHBG (p < 0.01). During the follow-up, no one in the sample developed diabetes. The annualised incidence rate for conversion from normoglycaemia to prediabetes totalled 4.5%. Baseline BMI, free androgen index, fasting glucose and M-clamp value were identified as prediabetes predictors in young PCOS women (respectively, OR = 1.17, OR = 1.42, OR = 1.2, OR = 0.73, p < 0.05). Prediabetes appeared in 76.47% of the women with a final BMI of ≥ 25 kg/m2 and in 7.14% of the normal-weight women (p = 0.0001). In conclusion, we report a high rate of adverse change in glucose metabolism in overweight and obese participants, a deterioration in β-cell function and strong correlations between metabolic parameters assessed in the third and the fourth decade in PCOS women, emphasising the role of early intervention to prevent cardiometabolic diseases.

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“…If insulin resistance is accentuated among obese PCOS women, these women should be at a greater risk of developing type 2 diabetes. Available data support this connection [ 39 , 40 ]. However, in the DHS, the average glucose levels and percentage of women with fasting glucose levels >100 mg/dL were not increased in PCOS women.…”

Section: Discussionmentioning

confidence: 88%

Metabolic Concomitants of Obese and Nonobese Women With Features of Polycystic Ovarian Syndrome

Boumosleh

Grundy

Phan

et al. 2017

Journal of the Endocrine Society

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Context:Polycystic ovarian syndrome (PCOS) is often associated with obesity and diabetes.Objective:The present study measured body fat distribution and metabolic risk factors in women with features of PCOS.Design:Cross-sectional, multiethnic study of cardiovascular risks.Setting:General community.Study Participants:145 PCOS and 344 non-PCOS women.Exposure Measures:Body composition by dual x-ray absorptiometry; abdominal fat masses measured by magnetic resonance imaging and hepatic triglyceride by magnetic resonance spectroscopy.Outcomes Measures:Body composition, liver fat content, homeostatic model assessment for insulin resistance (HOMA-IR), revised, and metabolic syndrome components.Results:PCOS women had a higher free androgen index compared with the non-PCOS women. Nonobese PCOS and non-PCOS women had a similar body fat content and distribution, HOMA-IR, and hepatic triglyceride content. Obese PCOS women had a similar total body fat percentage compared with their non-PCOS counterparts (41.4% and 41.4% respectively). Both obese groups had similar intraperitoneal fat (1.4% of total body mass in PCOS vs 1.4% in non-PCOS). However, obese PCOS women had a greater ratio of truncal/lower body fat (1.42 vs 1.27; P < 0.016). They also had greater insulin resistance (HOMA-IR: PCOS, 2.24% vs non-PCOS, 1.91%; P < 0.016), higher liver triglyceride content (6.96% in PCOS vs 4.44% in non-PCOS; P < 0.016), and a greater incidence of hypertension (33% vs 24%; P < 0.05). No differences were observed in other metabolic risk factors.Conclusions:Both obese and nonobese women with PCOS features had a greater free androgen index compared with non-PCOS women, but neither had greater intraperitoneal fat or abnormal lipid levels. Obese, but not nonobese, women with PCOS had a greater truncal/lower extremity fat ratio, HOMA-IR, and liver triglyceride content.

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Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study

Cited by 131 publications

References 33 publications

Polycystic ovary syndrome and risk factors for gestational diabetes

Polycystic ovary syndrome and risk factors for gestational diabetes

Changes in Metabolic Profile in the Women with a History of PCOS—A Long-Term Follow-Up Study

Metabolic Concomitants of Obese and Nonobese Women With Features of Polycystic Ovarian Syndrome

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