OPEN-Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
Department of Endocrinology, Odense University Hospital, 5000 Odense C, Denmark.
J Clin Endocrinol Metab. 2017 Oct 1;102(10):3848-3857. doi: 10.1210/jc.2017-01354.
Polycystic ovary syndrome (PCOS) is associated with insulin resistance and obesity. Prospective population-based data regarding development and possible predictors of type 2 diabetes (T2D) in PCOS are limited.
National Patient Register-based study.
Patients with PCOS [PCOS Denmark and embedded cohort, PCOS Odense University Hospital (OUH)] and a control population with no previous diagnosis of T2D. PCOS OUH (N = 1,162) included premenopausal women with PCOS and standardized clinical and biochemical examination. PCOS Denmark (N = 18,477) included women with PCOS in the Danish National Patient Register. Three age-matched controls were included per patient (N = 54,680).
T2D events according to diagnosis codes and filled medicine prescriptions.
The median (quartiles) follow-up was 11.1 (6.9 to 16.0) years. The hazard ratio (HR) with 95% confidence interval (CI) for development of T2D in PCOS Denmark was HR = 4.0 (95% CI, 3.7 to 4.3; P < 0.001), and the total event rate of T2D was 8.0 per 1000 person years in PCOS Denmark vs 2.0 per 1000 person years in controls (P < 0.001). The median age at diagnosis of T2D was 31 (26 to 37) years in PCOS Denmark vs 35 (27 to 44) years in controls (P < 0.001). In multiple regression analyses, body mass index, glycated hemoglobin, fasting blood glucose, 2-hour blood glucose, homeostasis model assessment of insulin resistance, and triglycerides were positively associated with development of T2D, whereas higher number of births was negatively associated with development of T2D.
The event rate of T2D was higher in PCOS compared with controls, and T2D was diagnosed at a younger age.
多囊卵巢综合征（PCOS）与胰岛素抵抗和肥胖有关。关于 PCOS 患者发展为 2 型糖尿病（T2D）的前瞻性人群数据以及可能的预测因素有限。
基于国家患者登记处的研究。
PCOS 患者[丹麦多囊卵巢综合征登记处和嵌入队列、奥胡斯大学医院多囊卵巢综合征（PCOS OUH）]和无 T2D 既往诊断的对照人群。PCOS OUH（N=1162）纳入了绝经前的 PCOS 患者，并进行了标准化的临床和生化检查。丹麦多囊卵巢综合征登记处（N=18477）纳入了丹麦国家患者登记处的 PCOS 患者。每位患者纳入 3 名年龄匹配的对照者（N=54680）。
根据诊断代码和用药处方确定 T2D 事件。
中位（四分位间距）随访时间为 11.1（6.9 至 16.0）年。丹麦多囊卵巢综合征登记处的 PCOS 患者发生 T2D 的风险比（HR）及其 95%置信区间（CI）为 HR=4.0（95%CI，3.7 至 4.3；P<0.001），且 T2D 的总事件率在 PCOS 丹麦登记处为 8.0/1000 人年，而在对照组中为 2.0/1000 人年（P<0.001）。在丹麦多囊卵巢综合征登记处，T2D 的诊断中位年龄为 31（26 至 37）岁，而在对照组中为 35（27 至 44）岁（P<0.001）。在多元回归分析中，体重指数、糖化血红蛋白、空腹血糖、2 小时血糖、胰岛素抵抗稳态模型评估和甘油三酯与 T2D 的发生呈正相关，而生育次数越多，T2D 的发生风险越低。
与对照组相比，PCOS 患者的 T2D 发生率更高，且 T2D 的诊断年龄更小。
