What Causes Diabetes in Women With Polycystic Ovarian Syndrome?

Highlights

• Women who have PCOS also face a higher risk of developing other health problems, such as diabetes.
• The risk of developing diabetes is four times greater in women with polycystic ovary syndrome (PCOS).
• Diabetes is diagnosed four years earlier in women with PCOS.

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among young women and a leading cause of infertility. Worldwide, 4 to 8% women are affected with PCOS. Hormonal Effects Of PCOS

In polycystic ovary disease, the ovaries are enlarged, with a thick, scarred capsule associated with an abnormally high number of follicles in the ovaries. This gives the impression of multiple cysts and hence the term ‘polycystic’.

Women with PCOS produce more testosterone and less estrogen and progesterone than normal. The elevated levels in women with PCOS can contribute to irregular or absent menstrual periods, infertility, weight gain, acne or excess hair on the face and body. Women who have PCOS also face a higher risk of developing other health problems, such as diabetes.

A new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism finds that women who have PCOS have a higher risk of developing type 2 diabetes (T2D) and are diagnosed at an earlier age with the condition.

"Many women with PCOS are obese, but the risk for the development of diabetes in PCOS is unknown," said one of the study's authors, Dorte Glintborg, M.D., Ph.D., of the Odense University Hospital in Denmark.

Risk of Diabetes In Women With PCOS

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The research team studied two populations with PCOS to determine the risk of T2D development. The first group was an all pre-menopausal Danish women with a diagnosis of PCOS in the National Patient Register (18,477 women) and a local sub-group of 1,162 women with PCOS who were examined at Odense University Hospital in Denmark.

All the participants were tested for insulin and glucose levels, cholesterol, triglycerides and testosterone levels. Women with PCOS were compared with age-matched females who did not have the disorder, nor a previous diagnosis of T2D. Three women without PCOS were randomly selected from the Nation Patient register for each woman with PCOS.

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The research team found that

• Women with PCOS were four times more likely to develop T2D compared to their counterparts who did not have the disorder.
• The average age for women with PCOS who received a diagnosis of T2D was 31 years. The average age for women without PCOS and diagnosed with T2D was 35 years.
• Higher body mass index, insulin and glucose levels, and triglycerides were positively associated with development of T2D
• A higher number of births were negatively associated with the development of T2D

Screening For Diabetes at An Early Stage

"The increased risk of developing T2D in PCOS is an important finding," Glintborg said. "Diabetes may develop at a young age and screening for diabetes is important, especially in women who are obese and have PCOS."

The study's authors note that BMI and fasting blood glucose levels are the best predictors of the development of T2D in patients with PCOS.

Increasing age, however, should not be included in future guidelines as a risk factor because most cases of diabetes in this study were found before the age of 40. The authors add that further research is needed to evaluate the effect of oral contraceptives and number of births for the risk of T2D development in PCOS.

Reference

1. Glintborg et al., Development and risk factors of type 2 diabetes in a nationwide population of women with polycystic ovary syndrome, Journal of Clinical Endocrinology and Metabolism (2017) http://dx.doi.org/10.1210/jc.2017-01354.

Source-Medindia