Background: Polycystic Ovary Syndrome (PCOS) is associated with insulin resistance, hyperandrogenism and dyslipidaemia but the effects of these disturbances on long-term health are not known.
Aims: To determine the relative risk of diabetes, cancer, large vessel disease (LVD) and death for young women diagnosed with PCOS.
Design: Data were extracted from The General Practice Research Database (GPRD), a longitudinal, anonymised research database derived from over 590 primary care practices in the UK. Patients with a diagnosis of PCOS between 1990 and 2010 were selected. Patients were matched to two sets of controls at a ratio of 1:4. The first set were matched according to primary care practice and age, and the second were also matched on body mass index (BMI). Primary outcome was first incident record of diabetes. Crude rates for diabetes were presented and time to diabetes was analysed using Cox proportional hazard models (CPHM). Models were also created for PCOS patients stratified by therapy type. Secondary outcomes (cancer, LVD and death) were also modelled.
Results: Of 53,303 women identified with a diagnosis of PCOS, 21,896 (41.1%) met the eligibility criteria. Crude rates of diabetes were 6.7 and 2.0 per 1,000 patient years (kpy) for cases and controls respectively. In the CPHM, the hazard ratio (HR) was 3.057 (95%CI 2.7933.347, P<0.001). Of cases matched by BMI, crude rates of diabetes were 6.2 and 3.1 per kpy respectively. In the CPHM, the HR was 1.824 (95% CI 1.6042.073). No significant difference in BMI-adjusted risk was found for cancer, LVD or death in either analysis.
Conclusions: Young women with PCOS are not at increased risk of LVD, cancer or death but have a significantly increased risk of diabetes which is modified by BMI.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.