Polycystic ovary syndrome in type 2 diabetes: does it predict a more severe phenotype?

In women with type 2 diabetes, a history of polycystic ovary syndrome is associated with an earlier onset of diabetes, higher body mass index, and higher rate of gestational diabetes and pregnancy hypertension.

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Volume 106, Issue 5, Pages 1258-1263

Authors:

Stephanie Y.T. Sim, M.B.B.S., Sian L. Chin, M.B.B.S., Jocelyn L.K. Tan, B.Sc., M.Sc., Suzanne J. Brown, B.Sc., Andrea J. Cussons, M.B.B.S., F.R.A.C.P., Ph.D., Bronwyn G.A. Stuckey, M.B.B.S., F.R.A.C.P.

Abstract:

Objective

To examine the prevalence of a history of polycystic ovary syndrome (PCOS) in women with type 2 diabetes (DM2) and to compare metabolic and reproductive outcomes between women with and without PCOS.

Design

Cross-sectional study.

Setting

Tertiary hospital.

Patient(s)

Female inpatients age 18–75 years with DM2.

Intervention(s)

A face-to-face questionnaire was administered.

Main Outcome Measure(s)

Age at diagnosis of diabetes, history of gestational diabetes, family history of diabetes, and reproductive history, fertility history, number of miscarriages, and morbidity in pregnancy.

Result(s)

One hundred seventy-one inpatients with DM2 participated. The prevalence of a history of PCOS was 37%. Women with PCOS had an earlier mean age of diagnosis of DM2 (44.2 vs. 48.8 years), higher recalled peak body mass index (BMI; 43.1 kg/m2 vs. 36.8 kg/m2), higher rate of gestational diabetes (28% vs. 18%), and higher rate of hypertension in pregnancy (40% vs. 22%). Women with PCOS were less likely to have a family history of DM2 than those without PCOS (45% vs. 67%).

Conclusion(s)

A history of PCOS in women with DM2 is associated with earlier onset of DM2, higher BMI, and a more severe phenotype. Since PCOS subjects were less likely to have a family history of DM2, lack of a family history of DM2 in women with PCOS is not reassuring for DM2 risk. We recommend identifying PCOS in early life and intervening to reduce the risk of diabetes and its comorbidities and suboptimal reproductive outcomes.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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