Journal Article

Development of type 2 diabetes in adolescent girls with polycystic ovary syndrome and obesity

Zeitler, Philip, Pyle, Laura, Hudnut‐Beumler, Julia, Taylor, Anya, Nadeau, Kristen J., Kaar, Jill L., Kelsey, Megan M., Cree‐Green, Melanie, Snell‐Bergeon, Janet

2021

Overview

Objective Adult women with polycystic ovary syndrome (PCOS) and obesity have an 8‐fold increased risk of developing type 2 diabetes (T2D). Our goal was to determine the incidence and risk factors for T2D in adolescents with PCOS and obesity. Research design and methods Retrospective chart review of girls aged 11–21 years with confirmed PCOS (oligomenorrhea and hyperandrogenism) diagnosis between July 2013 and Aug 2018 and at least one follow‐up visit and BMI >85%ile. T2D incidence, defined with an HbA1c ≥6.5%, was calculated. A nested case–control study with 1:3 matching by race, ethnicity, and BMI was performed to determine predictors of T2D diagnosis. Results Four hundred ninety‐three patients with PCOS (age 15.6 ± 1.9 years, BMI 36.2 ± 6.3 kg/m2) were identified with a follow‐up of 1018 person‐years. Twenty‐three developed T2D (incidence 22.6/1000 person‐years) with diagnosis a median of 1.8 years (2 months–5.5 years) after PCOS diagnosis. T2D risk was higher in girls with a prediabetes HbA1c (5.7%–6.4%) (HR 14.6 [4.8–44.5]) and among Hispanic girls with an elevated HbA1c and alanine aminotransferase (HR 19.0 [3.7–97.2]) at the time of PCOS diagnosis. In the 1:3 matched cohort, T2D risk was 18.7 times higher (OR 18.66 [2.27–153.24]) for every 0.1% increase in HbA1c at the time of PCOS diagnoses. Conclusions Girls with PCOS and obesity have an 18‐fold increase in T2D incidence compared to published rates in non‐PCOS youth. Hispanic girls with elevated HbA1c and ALT are at particular risk. Due to the morbidity associated with youth onset T2D, these findings argue for better screening and prevention approaches in this population.

• Publisher: John Wiley & Sons A/S,John Wiley & Sons, Inc
• Subject: Adolescent / adolescents / Alanine / Alanine transaminase / Body Mass Index / Case-Control Studies / Cohort Studies / Diabetes / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - epidemiology / Diabetes Mellitus, Type 2 - etiology / Diabetes Mellitus, Type 2 - pathology / Diagnosis / Female / Girls / Humans / Incidence / Morbidity / Obesity / Obesity - complications / Obesity - epidemiology / Obesity - pathology / Oligomenorrhea / Ovaries / Polycystic ovary syndrome / Polycystic Ovary Syndrome - complications / Polycystic Ovary Syndrome - epidemiology / Polycystic Ovary Syndrome - pathology / Prediabetic State - complications / Prediabetic State - epidemiology / Prediabetic State - pathology / Retrospective Studies / Risk Factors / Teenagers / type 2 diabetes / United States - epidemiology