Progression to prediabetes or diabetes in young Korean women with polycystic ovary syndrome: A longitudinal observational study

Choi, Young Min; Hwang, Kyu Ri; Oh, Sungchan; Lee, Dayong; Chae, Suchan; Yoon, Sang Ho; Kim, Jin Ju

doi:10.1111/cen.14416

Cited by 6 publications

(19 citation statements)

References 30 publications

(47 reference statements)

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“…The studies were published 2010–2021 and performed in European [ 8 , 9 , 18 , 29 , 34 , 35 , 37 ], Northern American [ 31 , 32 ], Asian [ 26 , 28 , 30 , 33 ], and Oceanic [ 25 , 27 ] study cohorts. No study was conducted in Southern American or African study cohorts.…”

Section: Resultsmentioning

confidence: 99%

Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome

et al. 2022

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Background: Polycystic ovary syndrome (PCOS) is associated with obesity and increased risk for type 2 diabetes (T2D). However, the prospective risk of T2D in normal weight women with PCOS is debated, together with the relevant prospective screening programs for T2D in normal weight women with PCOS. Aim: To review and discuss prospective risk of T2D in normal weight women with PCOS, and to give recommendations regarding prospective screening for T2D in normal weight women with PCOS. Methods: Systematic review. Results: A systematic literature search resulted in 15 published prospective studies (10 controlled studies and 5 uncontrolled studies) regarding risk of T2D in study cohorts of PCOS, where data from normal weight women with PCOS were presented separately. In controlled studies, higher risk of T2D in normal weight women with PCOS compared to controls was reported in 4/10 studies, which included one study where T2D diagnosis was based on glucose measurement, two register-based studies, and one study where diagnosis of T2D was self-reported. Six of the 10 controlled studies reported no increased risk of T2D in normal weight women with PCOS. Four of these studies based the diagnosis of T2D on biochemical measurements, which supported the risk of surveillance bias in PCOS. In uncontrolled studies, 2/5 reported a higher risk of T2D in lean women with PCOS compared to the general population. We discuss the evidence for insulin resistance and β-cell dysfunction in normal weight women with PCOS, and aggravation in the hyperandrogenic phenotype, ageing women, and women with Asian ethnicity. Impaired glucose tolerance could be an important metabolic and vascular risk marker in PCOS. Conclusions: The risk of T2D may be increased in some normal weight women with PCOS. Individual risk markers such as hyperandrogenism, age >40 years, Asian ethnicity, and weight gain should determine prospective screening programs in normal weight women with PCOS.

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Section: Resultsmentioning

confidence: 99%

Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome

et al. 2022

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“…Characteristics of studies included in this review are outlined in Table 1. Seven of the studies were conducted in the United States, 27,36,39–41,44,56 six in Italy, 29–31,38,48,49 three studies in Iran, 26,45,50 three in Sweden 37,51,52 and each of the remaining 12 studies were conducted in Australia, 53 the Netherlands, 28 Denmark, 54 Turkey, 32 Bosnia, 55 Thailand, 46 Venezuela, 43 Spain and Germany, 35 Croatia, 34 Poland, 42 Korea 33 and Hong Kong 47 …”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies reported change in BMI, 28–32,34,35,37,39,40,42,47,49,50,52–54 10 studies reported changes in lipid profiles, 26,29,34,40,42,44,47–50,52,54,56 10 studies described HTN, 26,40,42,44,47,48,50,52,54,56 T2DM risk was reported by 11 studies 27,32,33,36,38,45–47,50,55,56 and 15 studies reported IR and/or IGT 28,29,31,32,34,36,40,42–44,47,48,50,52,54 . The majority of investigators described more than two outcomes, which explains the overlap in a number of studies.…”

Section: Resultsmentioning

confidence: 99%

“…Five of seven studies 33,45,47,50,56 indicated that women with PCOS have a significantly higher incidence of T2DM compared to those without PCOS (Table 3c). In another study, 27 the risk of T2DM was significantly higher in PCOS than in controls, but only in women with a BMI of ≥35 kg/m 2 ; the risk of T2DM was similar between groups in women with a BMI of <35 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

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Natural history of polycystic ovary syndrome: A systematic review of cardiometabolic outcomes from longitudinal cohort studies

Kiconco

Tay

Rassie

et al. 2021

Clinical Endocrinology

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Objective Women with polycystic ovary syndrome (PCOS) have a worsened metabolic profile but the progression of cardiometabolic features over time is unclear. Understanding this natural history is a key priority in PCOS research and vital for guiding the prevention and management of this common condition. We explored cardiometabolic changes that are observed in women with PCOS compared to those without PCOS across the life course. Design, Patients and Measurements A systematic review of longitudinal cohort studies was conducted across MEDLINE, EMBASE, Ovid PsycInfo, CINAHL PLUS and EBM reviews between 15 January 2020 and 11 February 2021. Eligible studies included participants with or without PCOS diagnosed according to the 2003 Rotterdam or the 1990 National Institutes of Health (NIH) criteria. We included studies that were published from the year 1990 to 2021 with data on cardiometabolic outcomes as per the PCOS core outcomes set. Results There were 31 longitudinal studies with 28,316 participants from four continents. At the start of follow up, participants were aged between 1 year and 49 years with a follow‐up period ranging from 2 to 32 years. Changes in BMI and the risk of coronary heart disease were similar in adult women with and without PCOS. Women with PCOS had a higher risk of Type 2 diabetes than their non‐PCOS counterparts. Evidence for the majority of all other outcomes was conflicting and with inadequate data. Conclusion Understanding the natural history of PCOS and particularly changes in cardiometabolic features remains challenging. Existing literature is extensive but heterogeneous and inconsistent. Longitudinal studies in unselected populations are needed to provide high‐quality data in this area.

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“…The prevalence of type 2 diabetes in women with PCOS is significantly increased regardless of age (odds ratio, 2.87; 95% confidence interval, 1.44–5.72) compared to women without PCOS, and this relationship is independent of, yet exacerbated by, obesity [ 12 ]. The prevalence of type 2 diabetes in young Korean women with PCOS (mean age, 24.7±5.8 years) was 3.0% (27/899) in our recent study [ 13 ], whereas that of the young population (15,050 women aged 20–29 years) in the Korean National Health Insurance Database was 0.3% [ 14 ]. Moreover, the incidence rate of type 2 diabetes was 9.3 per 1,000 person-years in women with PCOS, which was significantly higher ( p <0.0001) than that of the overall population of women aged 20–29 years (0.9 per 1,000 person-years).…”

Section: Managementmentioning

confidence: 99%

Update on polycystic ovary syndrome

Kim

2021

Clin Exp Reprod Med

Self Cite

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Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4–6 based on a lower percentile of 85%–90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

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Progression to prediabetes or diabetes in young Korean women with polycystic ovary syndrome: A longitudinal observational study

Cited by 6 publications

References 30 publications

Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome

Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome

Natural history of polycystic ovary syndrome: A systematic review of cardiometabolic outcomes from longitudinal cohort studies

Update on polycystic ovary syndrome

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