Ethnicity, Obesity, and the Prevalence of Impaired Glucose Tolerance and Type 2 Diabetes in PCOS: A Systematic Review and Meta-Regression

    March 2018 in “ Human Reproduction Update ”
    Nadira Sultana Kakoly, Mahnaz Bahri Khomami, Anju E. Joham, Shamil D. Cooray, Marie Misso, Robert J. Norman, Cheryce L. Harrison, Sanjeeva Ranasinha, Helena Teede, Lisa J. Moran
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    TLDR Women with PCOS are more likely to have impaired glucose tolerance and type 2 diabetes, especially if they are Asian or obese.
    The document presents a systematic review and meta-regression analysis that included 40 eligible studies, which examined the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) in women with polycystic ovary syndrome (PCOS). The analysis, which involved 4530 studies up to June 2016, found that women with PCOS had a significantly higher prevalence of IGT and T2DM, with odds ratios of 3.26 for IGT and 2.87 for T2DM. The prevalence varied by ethnicity, with the highest increase in Asia, followed by the Americas and Europe. Obesity was found to further increase the prevalence, and the use of self-report or administrative data for diagnosing diabetes doubled the prevalence. Despite the clear association between PCOS, ethnicity, and obesity with IGT and T2DM, the meta-regression did not identify specific contributors to the heterogeneity observed. The study underscores the importance of PCOS as a risk factor for dysglycemia and the need for accurate diabetes diagnostic methods, while also highlighting the influence of ethnicity and obesity.
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