Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
JAMA Netw Open. 2022 Feb 1;5(2):e2147454. doi: 10.1001/jamanetworkopen.2021.47454.
The prevalence of pediatric type 2 diabetes (T2D) is increasing globally. Girls with T2D are at risk of developing polycystic ovary syndrome (PCOS), but the prevalence of PCOS among girls with T2D is unknown.
To determine the prevalence of PCOS in girls with T2D and to assess the association of obesity and race with this prevalence.
In this systematic review and meta-analysis, MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science: Conference Proceedings Citation Index-Science, and the gray literature were searched from inception to April 4, 2021.
Two reviewers independently screened for studies with observational study design that recruited 10 or more participants and reported the prevalence of PCOS in girls with T2D.
Risk of bias was evaluated using a validated tool, and level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine criteria. A random-effects meta-analysis was performed. This study follows the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline.
The main outcome of this systematic review was the prevalence of PCOS in girls with T2D. Secondary outcomes included assessing the associations of obesity and race with PCOS prevalence.
Of 722 screened studies, 6 studies involving 470 girls with T2D (mean age at diagnosis, 12.9-16.1 years) met the inclusion criteria. The prevalence (weighted percentage) of PCOS was 19.58% (95% CI, 12.02%-27.14%; I2 = 74%; P = .002). Heterogeneity was moderate to high; however, it was significantly reduced after excluding studies that did not report PCOS diagnostic criteria, leading to a calculated prevalence (weighted percentage) of 24.04% (95% CI, 15.07%-33.01%; I2 = 0%; P = .92). Associations with obesity and race could not be determined because of data paucity.
In this meta-analysis, approximately 1 in 5 girls with T2D had PCOS, but the results of this meta-analysis should be considered with caution because studies including the larger numbers of girls did not report the criteria used to diagnose PCOS, which is a challenge during adolescence. The associations of obesity and race with PCOS prevalence among girls with T2D need further evaluation to help define at-risk subgroups and implement early assessment and treatment strategies to improve management of this T2D-related comorbidity.
全球范围内，儿童 2 型糖尿病（T2D）的患病率正在上升。患有 T2D 的女孩有患多囊卵巢综合征（PCOS）的风险，但患有 T2D 的女孩中 PCOS 的患病率尚不清楚。
确定患有 T2D 的女孩中 PCOS 的患病率，并评估肥胖和种族与该患病率的关联。
在这项系统评价和荟萃分析中，从建库到 2021 年 4 月 4 日，检索了 MEDLINE、Embase、CINAHL、Cochrane 对照试验中心注册库、Cochrane 系统评价数据库、Web of Science：会议论文索引-科学和灰色文献。
两位审查员独立筛选了具有观察性研究设计的研究，这些研究招募了 10 名或更多参与者，并报告了患有 T2D 的女孩中 PCOS 的患病率。
使用经过验证的工具评估偏倚风险，并使用牛津循证医学中心标准评估证据水平。进行了随机效应荟萃分析。本研究遵循观察性研究的荟萃分析（MOOSE）报告指南。
本系统评价的主要结局是患有 T2D 的女孩中 PCOS 的患病率。次要结局包括评估肥胖和种族与 PCOS 患病率的关联。
在 722 项筛选研究中，有 6 项研究符合纳入标准，共纳入 470 名患有 T2D 的女孩（诊断时的平均年龄为 12.9-16.1 岁）。PCOS 的患病率（加权百分比）为 19.58%（95%CI，12.02%-27.14%；I2=74%；P=0.002）。异质性为中到高度；然而，在排除未报告 PCOS 诊断标准的研究后，异质性显著降低，导致计算出的患病率（加权百分比）为 24.04%（95%CI，15.07%-33.01%；I2=0%；P=0.92）。由于数据缺乏，无法确定肥胖和种族的相关性。
在这项荟萃分析中，大约每 5 名患有 T2D 的女孩中就有 1 名患有 PCOS，但由于包括更多女孩的研究并未报告用于诊断 PCOS 的标准，因此应谨慎考虑本荟萃分析的结果，这在青春期是一个挑战。需要进一步评估肥胖和种族与患有 T2D 的女孩中 PCOS 患病率的相关性，以帮助确定高危亚组，并实施早期评估和治疗策略，以改善这种与 T2D 相关的合并症的管理。
