nach oben

Erschienen in:

01.03.2020 | Gynecologic Endocrinology and Reproductive Medicine

Prevalence of type 2 diabetes mellitus compared between lean and overweight/obese patients with polycystic ovarian syndrome: a 5-year follow-up study

verfasst von: Panicha Chantrapanichkul, Suchada Indhavivadhana, Thanyarat Wongwananuruk, Kitirat Techatraisak, Chongdee Dangrat, Nutchaya Sa-nga-areekul

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the prevalence of type 2 diabetes mellitus (T2DM) at the 5-year follow-up after polycystic ovarian syndrome (PCOS) diagnosis compared between lean and overweight/obese groups.

Methods

This retrospective cohort study included 400 prediabetes PCOS women who attended our clinic. Participants were divided into either the lean group (body mass index [BMI]: < 23 kg/m²) or the overweight/obese group (BMI: ≥ 23 kg/m²). Patient demographic, clinical characteristics, metabolic profiles, and laboratory values were collected and compared between groups at baseline and during follow-up for 5 years.

Results

At the end of the follow-up, overweight/obese group had a higher risk for developing T2DM than lean group (11.5% vs. 0.5%, p < 0.001). Lean group had a lower incidence of hypertension (3% vs. 38.5%, p < 0.001) and dyslipidemia (35% vs. 53.5%, p < 0.001) than overweight/obese group. The factors found to be independently associated with increased risk for developing T2DM were BMI ≥ 23 kg/m² (odds ratio [OR]: 1.075, p = 0.047), non-use of oral combined contraceptive pills (OR: 0.312, p = 0.028), and impaired fasting glucose at baseline (OR: 38.167, p < 0.001).

Conclusions

Overweight/obese PCOS patients were found to be at significantly higher risk for developing T2DM than lean PCOS patients. Higher BMI, IFG at baseline, and non-use of oral contraceptive pills found to be independent predictors of T2DM in PCOS.

Rotterdam EA-SPcwg (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19(1):41–47CrossRef

de Groot PC, Dekkers OM, Romijn JA, Dieben SW, Helmerhorst FM (2011) PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis. Hum Reprod Update 17(4):495–500. https://doi.org/10.1093/humupd/dmr001 CrossRefPubMed

Ollila MM, West S, Keinanen-Kiukaaniemi S, Jokelainen J, Auvinen J, Puukka K, Ruokonen A, Jarvelin MR, Tapanainen JS, Franks S, Piltonen TT, Morin-Papunen LC (2017) Overweight and obese but not normal weight women with PCOS are at increased risk of type 2 diabetes mellitus-a prospective population-based cohort study. Hum Reprod 32(4):968. https://doi.org/10.1093/humrep/dex030 CrossRefPubMedPubMedCentral

Pantasri T, Norman RJ (2014) The effects of being overweight and obese on female reproduction: a review. Gynecol Endocrinol 30(2):90–94. https://doi.org/10.3109/09513590.2013.850660 CrossRefPubMed

Leerasiri P, Wongwananuruk T, Indhavivadhana S, Techatraisak K, Rattanachaiyanont M, Angsuwathana S (2016) Correlation of clinical and biochemical hyperandrogenism in Thai women with polycystic ovary syndrome. J Obstet Gynaecol Res 42(6):678–683. https://doi.org/10.1111/jog.12945 CrossRefPubMed

Whitworth JA, World Health Organization ISoHWG (2003) 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21(11):1983–1992. https://doi.org/10.1097/01.hjh.0000084751.37215.d2 CrossRef

Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P, Expert Committee on the D, Classification of Diabetes M (2003) Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26(11):3160–3167CrossRefPubMed

Rossi G, American Diabetes A (2010) Diagnosis and classification of diabetes mellitus. Recenti Prog Med 101(7–8):274–276PubMed

American Diabetes A (2014) Diagnosis and classification of diabetes mellitus. Diabetes Care 37(Suppl 1):S81–90. https://doi.org/10.2337/dc14-S081 CrossRef

10.

Who Expert Consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363(9403):157–163CrossRef

11.

Douketis JD, Feightner JW, Attia J, Feldman WF (1999) Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. Canadian Task Force on Preventive Health Care. CMAJ 160(4):513–525PubMedPubMedCentral

12.

National Cholesterol Education Program Expert Panel on Detection E, Treatment of High Blood Cholesterol in A (2002) Third report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 106(25):3143–3421CrossRef

13.

Morales AJ, Laughlin GA, Butzow T, Maheshwari H, Baumann G, Yen SS (1996) Insulin, somatotropic, and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome: common and distinct features. J Clin Endocrinol Metab 81(8):2854–2864. https://doi.org/10.1210/jcem.81.8.8768842 CrossRefPubMed

14.

Dunaif A, Finegood DT (1996) Beta-cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. J Clin Endocrinol Metab 81(3):942–947. https://doi.org/10.1210/jcem.81.3.8772555 CrossRefPubMed

15.

Gabir MM, Hanson RL, Dabelea D, Imperatore G, Roumain J, Bennett PH, Knowler WC (2000) The 1997 American Diabetes Association and 1999 World Health Organization criteria for hyperglycemia in the diagnosis and prediction of diabetes. Diabetes Care 23(8):1108–1112CrossRefPubMed

16.

Shaw JE, Zimmet PZ, de Courten M, Dowse GK, Chitson P, Gareeboo H, Hemraj F, Fareed D, Tuomilehto J, Alberti KG (1999) Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care 22(3):399–402CrossRefPubMed

17.

Pasquali R, Gambineri A, Anconetani B, Vicennati V, Colitta D, Caramelli E, Casimirri F, Morselli-Labate AM (1999) The natural history of the metabolic syndrome in young women with the polycystic ovary syndrome and the effect of long-term oestrogen-progestagen treatment. Clin Endocrinol (Oxf) 50(4):517–527CrossRef

18.

Kim C, Siscovick DS, Sidney S, Lewis CE, Kiefe CI, Koepsell TD, Study C (2002) Oral contraceptive use and association with glucose, insulin, and diabetes in young adult women: the CARDIA Study. Coronary artery risk development in young adults. Diabetes Care 25(6):1027–1032CrossRef

19.

Kahn JA, Gordon CM (1999) Polycystic ovary syndrome. Adolesc Med 10(2):321–336PubMed

20.

Godsland IF (1996) The influence of female sex steroids on glucose metabolism and insulin action. J Intern Med Suppl 738:1–60PubMed

21.

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 289(1):76–79CrossRefPubMed

22.

Kahn SE, Hull RL, Utzschneider KM (2006) Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 444(7121):840–846. https://doi.org/10.1038/nature05482 CrossRefPubMed

23.

Aneja A, El-Atat F, McFarlane SI, Sowers JR (2004) Hypertension and obesity. Recent Prog Horm Res 59:169–205CrossRefPubMed

24.

Joham AE, Boyle JA, Zoungas S, Teede HJ (2015) Hypertension in reproductive-aged women with polycystic ovary syndrome and association with obesity. Am J Hypertens 28(7):847–851. https://doi.org/10.1093/ajh/hpu251 CrossRefPubMed

25.

Chen MJ, Yang WS, Yang JH, Chen CL, Ho HN, Yang YS (2007) Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome. Hypertension 49(6):1442–1447. https://doi.org/10.1161/HYPERTENSIONAHA.106.083972 CrossRefPubMed

26.

Lotta LA, Sharp SJ, Burgess S, Perry JRB, Stewart ID, Willems SM, Luan J, Ardanaz E, Arriola L, Balkau B, Boeing H, Deloukas P, Forouhi NG, Franks PW, Grioni S, Kaaks R, Key TJ, Navarro C, Nilsson PM, Overvad K, Palli D, Panico S, Quirós JR, Riboli E, Rolandsson O, Sacerdote C, Salamanca EC, Slimani N, Spijkerman AM, Tjonneland A, Tumino R, van der A DL, van der Schouw YT, McCarthy MI, Barroso I, O'Rahilly S, Savage DB, Sattar N, Langenberg C, Scott RA, Wareham NJ (2016) Association between low-density lipoprotein cholesterol–lowering genetic variants and risk of type 2 diabetes: a meta-analysis. JAMA 316(13):1383–1391CrossRefPubMedPubMedCentral

27.

Athyros VG, Mikhailidis DP (2012) Pharmacotherapy: statins and new-onset diabetes mellitus—a matter for debate. Nat Rev Endocrinol 8(3):133–134CrossRefPubMed

28.

Sitruk-Ware R, Nath A (2013) Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab 27(1):13–24. https://doi.org/10.1016/j.beem.2012.09.004 CrossRefPubMed

Titel: Prevalence of type 2 diabetes mellitus compared between lean and overweight/obese patients with polycystic ovarian syndrome: a 5-year follow-up study
verfasst von: Panicha Chantrapanichkul
Suchada Indhavivadhana
Thanyarat Wongwananuruk
Kitirat Techatraisak
Chongdee Dangrat
Nutchaya Sa-nga-areekul
Publikationsdatum: 01.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 3/2020
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05423-2

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Prevalence of type 2 diabetes mellitus compared between lean and overweight/obese patients with polycystic ovarian syndrome: a 5-year follow-up study