Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Center for Diabetes and Endocrine Research, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Endocrine. 2021 Nov;74(2):245-253. doi: 10.1007/s12020-021-02801-2. Epub 2021 Jun 26.
The exact risk of type 2 diabetes mellitus (T2DM) in women with polycystic ovary syndrome (PCOS) is unknown. It is also unclear if obesity independently increases T2DM risk in this population. The aim of this study was to systematically review and synthesize the best available evidence regarding the association between PCOS and T2DM, stratified according to obesity status.
A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases up to October 31, 2020. Data are expressed as relative risk (RR) with 95% confidence interval (CI). The I index was employed for heterogeneity.
The eligibility criteria were fulfilled by 23 studies (319,780 participants; 60,336 PCOS and 8847 type 2 diabetes cases). Women with PCOS demonstrated a higher risk of T2DM than those without PCOS (RR 3.45, 95% CI, 2.95-4.05, p < 0.001; I 81.6%). This risk remained significant both in studies matched or unmatched for participants' age. With regard to body mass index (BMI), the RR for developing T2DM in obese and non-obese PCOS women compared with their non-PCOS counterparts was 3.24 (95% CI 2.25-4.65; p < 0.001; I 30.9%) and 1.62 (95% CI 0.14-18.50; p = 0.70; I 89.9%), respectively. The RR for developing T2DM was 3.85 (95% CI 1.99-7.43; p < 0.001; I 46.2%) in obese compared with non-obese women with PCOS. This was also the case for overweight compared with lean women with PCOS.
Women with PCOS present an increased risk of T2DM compared with non-PCOS women only if they are obese/overweight.
多囊卵巢综合征(PCOS)女性 2 型糖尿病(T2DM)的确切风险尚不清楚。肥胖是否会独立增加该人群的 T2DM 风险也不清楚。本研究旨在系统回顾和综合评估 PCOS 与 T2DM 之间关联的最佳证据,根据肥胖状况进行分层。
在 PubMed、CENTRAL 和 Scopus 数据库中进行全面检索,检索时间截至 2020 年 10 月 31 日。数据以相对风险(RR)及其 95%置信区间(CI)表示。采用 I 指数评估异质性。
符合纳入标准的研究有 23 项(共纳入 319780 名参与者,其中 60336 名为 PCOS 患者,8847 名为 T2DM 患者)。与非 PCOS 患者相比,PCOS 患者发生 T2DM 的风险更高(RR 3.45,95%CI 2.95-4.05,p<0.001;I 81.6%)。无论在参与者年龄匹配或不匹配的研究中,这种风险均具有统计学意义。关于体重指数(BMI),与非 PCOS 对照组相比,肥胖和非肥胖 PCOS 女性发生 T2DM 的 RR 分别为 3.24(95%CI 2.25-4.65;p<0.001;I 30.9%)和 1.62(95%CI 0.14-18.50;p=0.70;I 89.9%)。与非肥胖 PCOS 女性相比,肥胖 PCOS 女性发生 T2DM 的 RR 为 3.85(95%CI 1.99-7.43;p<0.001;I 46.2%)。对于超重 PCOS 女性,与非肥胖 PCOS 女性相比,发生 T2DM 的 RR 也是如此。
只有肥胖/超重的 PCOS 女性发生 T2DM 的风险才会高于非 PCOS 女性。