Risk of type 2 diabetes in 99,892 nordic women with polycystic ovary syndrome and 446,055 controls: national cohort study from Denmark, Finland and Sweden

Dorte Glintborg; Meri-Maija Ollila; Jens-Jakob Moller; Paula Pesonen; Sofia Persson; Evangelia Elenis; Katrine Rubin; Mika Gissler; Marianne Andersen; Inger Sundstrom-Poromaa; Terhi Piltonen

doi:10.1530/endoabs.99.P263

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Endocrine Abstracts (2024) 99 P263 | DOI: 10.1530/endoabs.99.P263

ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)

Risk of type 2 diabetes in 99,892 nordic women with polycystic ovary syndrome and 446,055 controls: national cohort study from Denmark, Finland and Sweden

Dorte Glintborg ^1,2 , Meri-Maija Ollila ³ , Jens-Jakob Møller ⁴ , Paula Pesonen ³ , Sofia Persson ⁵ , Evangelia Elenis ⁵ , Katrine Rubin ^1,6 , Mika Gissler ^7,8,9 , Marianne Andersen ¹ , Inger Sundström-Poromaa ⁵ & Terhi Piltonen ³

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¹Odense University Hospital, Odense, Denmark; ²University of Southern Denmark, Odense, Denmark; ³Oulu University Hospital, Oulu, Finland; ⁴Odense University Hospital, OPEN, Odense, Denmark; ⁵Uppsala University Hospital, Sweden; ⁶University of Southern Denmark, OPEN research unit, Odense, Denmark; ⁷Helsinki, Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland, Helsinki, Finland; ⁸Region Stockholm, Academic Primary Health Care Centre, Sweden; ⁹Karolinska Institute, Department of Molecular Medicine and Surgery, Sweden

Background: The risk of type 2 diabetes (T2D) in PCOS is associated with BMI, but prospective data regarding risk of T2D in PCOS are limited. We investigated prospective risk of T2D in Nordic women with PCOS compared to controls.

Methods: National register-based study in women with PCOS and age-matched controls originating from Denmark (PCOS Denmark, (n=27,016, controls, (n=133,994), Finland (PCOS Finland, (n=20,467, controls, (n=58,051), and Sweden (PCOS Sweden, (n=52,409, controls, (n=254,010). The main study outcome was T2D occurring after PCOS diagnosis. T2D was defined according to ICD-10 diagnosis codes and/or filled medicine prescriptions. Cox regression analyses were adjusted for BMI and length of education.

Findings: The median age at cohort entry was 28 years in PCOS Denmark, Finland and Sweden with median follow-up time (interquartile range) in women with PCOS of 8.5 (4.0; 14.8), 9.8 (5.1; 15.1), and 6.0 (2.0; 10.0) years, respectively. The crude hazard ratio (HR, 95% CI) for T2D in women with PCOS was 4.28 (3.98 –4.60) in Denmark, 3.40 (3.11 - 3.74) in Finland and 5.68 (5.20 –6.21) in Sweden. In adjusted regression analyses, BMI ≥ 30 vs < 25 kg/m² was associated with 7.6- to 11.3-fold risk of T2D. In a combined meta-analysis (PCOS, (n=99,892, controls, (n=446,055), the crude HR for T2D in PCOS was 4.64 (3.40 –5.87) and adjusted HR 2.92 (2.32 –3.51).

Interpretation: Diagnosis of PCOS and BMI ≥30 kg/m² represented a high-risk phenotype for prospective risk of T2D across Nordic countries.