Peninsula College of Medicine and Dentistry, Research and Development, Knowledge Spa, Royal Cornwall Hospital, Cornwall, UK.
Diabet Med. 2010 May;27(5):498-515. doi: 10.1111/j.1464-5491.2010.02994.x.
Polycystic ovary syndrome (PCOS) is a risk factor for Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), but these risks are poorly defined. This study aimed to evaluate the evidence for these risks and whether screening and risk reduction are feasible. Medline reviews and data quality analysis were used using standard tools. Results showed that (i) polycystic ovary syndrome is a risk factor forT2DM but the magnitude of risk is uncertain, (ii) fasting plasma glucose is an inadequate screening test forT2DM in this population and the oral glucose tolerance test is superior, (iii) the identification of women with PCOS for diabetes screening is constrained by current diagnostic criteria for PCOS; however, women with oligomenorrhoea and those with diagnosed PCOS and obesity or a family history of T2DM are at highest risk, (iv) risk factors for T2DM are improved by weight loss interventions and by metformin. However, no studies have determined whether T2DM incidence is reduced, (v) polycystic ovary syndrome is associated with cardiovascular disease (CVD) risk factors but data on CVD incidence are weak, (vi) risk factors for CVD are improved by the same interventions and statins and (vi) no studies have evaluated whether CVD incidence is reduced. While PCOS has important metabolic associations, and short-term interventions reduce risk factors for T2DM and CVD, data on prevalence and incidence of T2DM and particularly CVD are poor. There is a need for a clear definition of PCOS, for diabetes screening protocols and for long-term studies to determine whether risks can be reduced.
多囊卵巢综合征（PCOS）是 2 型糖尿病（T2DM）和心血管疾病（CVD）的危险因素，但这些风险的定义并不明确。本研究旨在评估这些风险的证据，以及筛查和降低风险是否可行。使用标准工具对 Medline 综述和数据质量分析进行了评估。结果表明：（i）多囊卵巢综合征是 T2DM 的危险因素，但风险的大小不确定；（ii）空腹血糖是该人群中 T2DM 筛查的不充分测试，口服葡萄糖耐量试验更优；（iii）目前的多囊卵巢综合征诊断标准限制了对患有 PCOS 的妇女进行糖尿病筛查；然而，月经稀少的妇女、患有多囊卵巢综合征且肥胖或有 T2DM 家族史的妇女风险最高；（iv）体重减轻干预和二甲双胍可改善 T2DM 的危险因素。但是，没有研究确定 T2DM 的发病率是否降低；（v）多囊卵巢综合征与心血管疾病（CVD）危险因素相关，但 CVD 发病率的数据较弱；（vi）相同的干预措施和他汀类药物可改善 CVD 的危险因素；（vi）没有研究评估 CVD 的发病率是否降低。虽然多囊卵巢综合征与重要的代谢相关，短期干预可降低 T2DM 和 CVD 的危险因素，但 T2DM 和特别是 CVD 的患病率和发病率数据较差。需要明确多囊卵巢综合征的定义，制定糖尿病筛查方案，并进行长期研究，以确定是否可以降低风险。
