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Progression of glucose intolerance and cardiometabolic risk factors over a decade in Chinese women with polycystic ovary syndrome: A case-control study

Authors :
Ng, Noel Yat Hey
Jiang, Guozhi
Cheung, Lai Ping
Zhang, Yuying
Tam, Claudia Ha Ting
Luk, Andrea On Yan
Quan, Jianchao
Lau, Eric Siu Him
Yau, Tiffany Tse Ling
Chan, Michael Ho Ming
Ho, Chung Shun
Lim, Cadmon King Poo
Ozaki, Risa
Huang, Jin
Liu, Kin Hung
Tam, Wing Hung
Sahota, Daljit Singh
Chu, Winnie Chiu Wing
Goggins, William
Woo, Jean
Li, Tin Chiu
Chow, Chun Chung
Chan, Juliana Chung Ngor
Ma, Ronald Ching Wan
Source :
PLoS Medicine. October 25, 2019, Vol. 16 Issue 10, e1002953
Publication Year :
2019

Abstract

Background Polycystic ovary syndrome (PCOS) is associated with increased metabolic risk, though data on long-term follow-up of cardiometabolic traits are limited. We postulated that Chinese women with PCOS would have higher risk of incident diabetes and cardiometabolic abnormalities than those without PCOS during long-term follow-up. Methods and findings One hundred ninety-nine Chinese women with PCOS diagnosed by the Rotterdam criteria and with a mean age of 41.2 years (SD = 6.4) completed a follow-up evaluation after an average of 10.6 ± 1.3 years. Two hundred twenty-five women without PCOS (mean age: 54.1 ± 6.7 years) who underwent baseline and follow-up evaluation over the same period were used for comparison. Progression of glycaemic status of women both with and without PCOS was assessed by using 75-g oral glucose tolerance test (OGTT) screening with the adoption of 2009 American Diabetes Association diagnostic criteria. The frequency of impaired glucose regulation, hypertension, and hyperlipidaemia of women with PCOS at follow-up has increased from 31.7% (95% CI 25.2%-38.1%) to 47.2% (95% CI 40.3%-54.2%), 16.1% (95% CI 11.0%-21.2%) to 34.7% (95% CI 28.1%-41.3%), and 52.3% (95% CI 45.3%-59.2%) to 64.3% (95% CI 57.7%-71.0%), respectively. The cumulative incidence of diabetes mellitus (DM) in follow-up women with PCOS is 26.1% (95% CI 20.0%-32.2%), almost double that in the cohort of women without PCOS (p < 0.001). Age-standardised incidence of diabetes among women with PCOS was 22.12 per 1,000 person-years (95% CI 10.86-33.37) compared with the local female population incidence rate of 8.76 per 1,000 person-years (95% CI 8.72-8.80) and 10.09 per 1,000 person-years (95% CI 4.92-15.26, p 0.05; overweight/obese: 28.64 [95% CI 19.55-40.60] versus 14.1 per 1,000 person-years [95% CI 8.20-22.76], p < 0.05). Logistic regression analysis identified that baseline waist-to-hip ratio (odds ratio [OR] = 1.71 [95% CI 1.08-2.69], p < 0.05) and elevated triglyceride (OR = 6.63 [95% CI 1.23-35.69], p < 0.05) are associated with the progression to T2DM in PCOS. Limitations of this study include moderate sample size with limited number of incident diabetes during follow-up period and potential selection bias. Conclusions High risk of diabetes and increased cardiovascular disease risk factors among Chinese women with PCOS are highlighted in this long-term follow-up study. Diabetes onset was, on average, 10 years earlier among women with PCOS than in women without PCOS.<br />Author(s): Noel Yat Hey Ng 1, Guozhi Jiang 1,2, Lai Ping Cheung 3, Yuying Zhang 1,2, Claudia Ha Ting Tam 1,2, Andrea On Yan Luk 1,2,4, Jianchao Quan 5, Eric [...]

Details

Language :
English
ISSN :
15491277
Volume :
16
Issue :
10
Database :
Gale General OneFile
Journal :
PLoS Medicine
Publication Type :
Academic Journal
Accession number :
edsgcl.607647048
Full Text :
https://doi.org/10.1371/journal.pmed.1002953