Abstract
Our aim was to determine the incidence of prediabetes and risk of developing cardiovascular disease (CVD) in women with polycystic ovary syndrome (PCOS). This prospective, observational study included 148 women with PCOS, without Type 2 diabetes mellitus (T2DM) and CVD present at baseline. In the fasting blood samples, we measured lipids, glucose, and insulin levels during oral glucose tolerance test, levels of C-reactive protein (CRP), steroids, 25-hydroxyvitamin D (25-OHD), prolactin, thyroid-stimulating hormone, and parathyroid hormone. The follow-up period was 3 years. At baseline, prevalent prediabetes was present in 18 (12%) of PCOS cases and it progressed to T2DM in 5 (3%) of the cases. Incident prediabetes during the follow-up was noted in 47 (32%) women or 4.7 per 1000 persons/year. Prediabetes was associated with elevated body mass index (BMI) (odds ratio [OR] = 1.089, confidence interval [CI]: 1.010; 1.174, p = 0.026), high baseline levels of CRP (OR = 3.286, CI: 1.299; 8.312, p = 0.012), homeostatic model assessment - insulin resistance (IR) (OR = 2.628, CI: 1.535; 4.498, p < 0.001), and high lipid accumulation product (LAP) (OR = 1.009, CI: 1.003; 1.016, p = 0.005). Furthermore, prediabetes was associated with low 25-OHD (OR = 0.795, CI: 0.724; 0.880, p ≤ 0.05). In addition, cardiovascular risk in PCOS women with prediabetes was high (hazard ratio = 1.092, CI: 1.036; 1.128, p < 0.001). We showed association of prediabetes with high BMI, IR, markers of inflammation, LAP, and low serum 25-OHD concentration. IR appears to be more relevant than the other predictors of prediabetes risk in this study. PCOS women are considered as a high-risk population for prediabetes.
Highlights
Polycystic ovary syndrome (PCOS) affects between 5% and 8% of women and is characterized by androgen excess and increased risk of diabetes and heart disease [1,2]
The risk of developing cardiovascular disease (CVD) according to prediabetes incidence in the women with PCOS was significant (HR = 1.092, CI: 1.036; 1.128, p < 0.001)
Insulin resistance (IR) appears to be more relevant than the other predictors of prediabetes risk in this study
Summary
Polycystic ovary syndrome (PCOS) affects between 5% and 8% of women and is characterized by androgen excess and increased risk of diabetes and heart disease [1,2]. Insulin resistance (IR) appears to be central to the pathogenesis of androgen excess in this population and contributes to dyslipidemia and endothelial dysfunction [4]. It Submitted: 23 May 2016/Accepted: 26 July 2016 is not surprising that PCOS is frequently associated with an increased risk for the development of cardiovascular disease (CVD) and metabolic syndrome [5]. Data on prevalence and incidence of T2DM, and data on CVD in PCOS patients, are very limited [7]. Inflammatory markers, such as C-reactive protein (CRP), were shown to be consistently associated with the incidence of T2DM in a population of otherwise healthy people [8] as well as in PCOS patients [9]
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