Liao WT, Huang JY, Lee MT, Yang YC, Wu CC. Higher risk of type 2 diabetes in young women with polycystic ovary syndrome: A 10-year retrospective cohort study. World J Diabetes 2022; 13(3): 240-250 [PMID: 35432752 DOI: 10.4239/wjd.v13.i3.240]
Corresponding Author of This Article
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
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
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 bythe 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 Processing time: 215 Days and 5.5 Hours
ARTICLE HIGHLIGHTS
Research background
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).
Research motivation
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.
Research objectives
We aimed to evaluate the incidence of T2DM over time in women with PCOS at different diagnosis ages, in comparison with non-PCOS controls.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
