Impaired Glucose Tolerance, Type 2 Diabetes and Metabolic Syndrome in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Moran, Lisa J.; Misso, Marie L.; Wild, Robert A.; Norman, Robert J.

doi:10.1093/humupd/dmq001

Cited by 1,108Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGestational Diabetes Research and Management

Impaired Glucose Tolerance, Type 2 Diabetes and Metabolic Syndrome in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Moran, Lisa J., Misso, Marie L., Wild, Robert A., Norman, Robert J.·2010·Human Reproduction Update

DOI 10.1093/humupd/dmq001

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Abstract

BACKGROUND Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women associated with impaired glucose tolerance (IGT), type 2 diabetes mellitus (DM2) and the metabolic syndrome. METHODS A literature search was conducted (MEDLINE, CINAHL, EMBASE, clinical trial registries and hand-searching) identifying studies reporting prevalence or incidence of IGT, DM2 or metabolic syndrome in women with and without PCOS. Data were presented as odds ratio (OR) [95% confidence interval (CI)] with fixed- and random-effects meta-analysis by Mantel-Haenszel methods. Quality testing was based on Newcastle-Ottawa Scaling and The Cochrane Collaboration's risk of bias assessment tool. Literature searching, data abstraction and quality appraisal were performed by two investigators. RESULTS A total of 2192 studies were reviewed and 35 were selected for final analysis. Women with PCOS had increased prevalence of IGT (OR 2.48, 95% CI 1.63, 3.77; BMI-matched studies OR 2.54, 95% CI 1.44, 4.47), DM2 (OR 4.43, 95% CI 4.06, 4.82; BMI-matched studies OR 4.00, 95% CI 1.97, 8.10) and metabolic syndrome (OR 2.88, 95% CI 2.40, 3.45; BMI-matched studies OR 2.20, 95% CI 1.36, 3.56). One study assessed IGT/DM2 incidence and reported no significant differences in DM2 incidence (OR 2.07, 95% CI 0.68, 6.30). One study assessed conversion from normal glucose tolerance to IGT/DM2 (OR 2.4, 95% CI 0.7, 8.0). No studies reported metabolic syndrome incidence. CONCLUSIONS Women with PCOS had an elevated prevalence of IGT, DM2 and metabolic syndrome in both BMI and non-BMI-matched studies. Few studies have determined IGT/DM2 or metabolic syndrome incidence in women with and without PCOS and further research is required.

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In our study and in other reports, those with PCOS are scarcely informed about cardiometabolic risk factors and long-term morbidity risk including dyslipidemia, insulin resistance, pre-diabetes, diabetes and cardiovascular disease.
“In our study and in other reports, those with PCOS are scarcely informed about cardiometabolic risk factors and long-term morbidity risk including dyslipidemia, insulin resistance, pre-diabetes, diabetes and cardiovascular disease [71–73].”
From Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care (2023) · cites this paper as [72]
The Introduction (page unavailable) identifies dyslipidaemia and insulin resistance as cardiometabolic risk factors in PCOS and discusses impaired glucose tolerance, type 2 diabetes and cardiovascular disease. It does not say that people with PCOS are scarcely informed about these risks; searches for patient awareness and information found no such passage. (LLM, conf=0.85)
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PCOS is linked with increased prevalence of cardiometabolic risk factors, including dyslipidemia, hypertension, chronic inflammation, impaired glucose tolerance, and overweight and obesity.
“PCOS is linked with increased prevalence of cardiometabolic risk factors, including dyslipidemia [10,11,12,13], hypertension [13,14,15], chronic inflammation, and impaired glucose tolerance [16,17], as well as overweight and obesity [18,19].”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [17]
Obesity exacerbates the symptoms of PCOS, especially regarding the risk for development of type 2 diabetes and the metabolic syndrome.
“One relatively consistent finding is that obesity exacerbates the symptoms of PCOS, especially regarding the risk for development of T2D and the metabolic syndrome [76].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [76]
Presentation of PCOS varies across the life span.
“Presentation varies across the life span.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
Metabolic challenges are most notable after the 20s and 30s.
“metabolic challenges most notable after this”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]

Fertility issues are most prominent among women in their 20s and 30s.
“fertility issues most prominent among women in their 20s and 30s”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
PCOS is associated with an increased prevalence of prediabetes and DM2.
“Metabolic features of PCOS include an apparent propensity for excess weight gain, an increased prevalence of prediabetes and DM2, a 5-10-fold risk of progression from prediabetes to DM2 and a 4-7-fold risk of DM2. 11”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
PCOS is associated with a 5-10-fold risk of progression from prediabetes to DM2.
“Metabolic features of PCOS include an apparent propensity for excess weight gain, an increased prevalence of prediabetes and DM2, a 5-10-fold risk of progression from prediabetes to DM2 and a 4-7-fold risk of DM2. 11”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
PCOS includes an apparent propensity for excess weight gain.
“Metabolic features of PCOS include an apparent propensity for excess weight gain, an increased prevalence of prediabetes and DM2, a 5-10-fold risk of progression from prediabetes to DM2 and a 4-7-fold risk of DM2. 11”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
PCOS is associated with a 4-7-fold risk of DM2.
“Metabolic features of PCOS include an apparent propensity for excess weight gain, an increased prevalence of prediabetes and DM2, a 5-10-fold risk of progression from prediabetes to DM2 and a 4-7-fold risk of DM2. 11”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]
Women with PCOS have increased Finnish Diabetes Risk Scores as well as increased risk of gestational diabetes, prediabetes and DM2, independent of but exacerbated by obesity.
“Women with PCOS have increased Finnish Diabetes Risk Scores as well as increased risk of gestational diabetes, 24 prediabetes and DM2 11,103 - independent of, but exacerbated by, obesity.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [11]

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Young Obese Women with Polycystic Ovary Syndrome Have Evidence of Early Coronary Atherosclerosis
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Vascular Dysfunction and Metabolic Parameters in Polycystic Ovary Syndrome
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Obesity and extreme obesity, manifest by ages 20–24 years, continuing through 32–41 years in women, should alert physicians to the diagnostic likelihood of polycystic ovary syndrome as a reversible underlying endocrinopathy
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Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7

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Authors: Moran, L. J., Misso, M. L., Wild, R. A., & Norman, R. J.
Affiliations: Jean Hailes (AU)
Monash University (AU)
OU Health (US)
The University of Adelaide (AU)
Corresponding author: Moran, Lisa J.
ORCID: Moran, Lisa J.
Misso, Marie L.
Wild, Robert A.
Norman, Robert J.
Venue: Human Reproduction Update
Publisher: Oxford University Press (OUP)
Published: 2010
Volume: 16
Issue: 4
Pages: 347-363
ISSN: 1355-4786 (ISSN-L)
1460-2369
DOI: 10.1093/humupd/dmq001
OpenAlex: W2101316067
Cited by: 1,108
References: 128
Citations by year: 2026: 64 · 2025: 78 · 2024: 51 · 2023: 68 · 2022: 80 · 2021: 75 · 2020: 61 · 2019: 84 · 2018: 83 · 2017: 77 · 2016: 78 · 2015: 84 · 2014: 82 · 2013: 55 · 2012: 43
FWCI: 6.41
Type: journal article
Language: en
Open access: closed
Locations: Human Reproduction Update (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords: polycystic ovary syndrome, impaired glucose tolerance, type 2 diabetes, metabolic syndrome, prevalence, incidence, body mass index, women's health
MeSH terms: Diabetes Mellitus, Type 2, Female, Humans, Polycystic Ovary Syndrome, United States, Body Mass Index, Incidence, Prevalence, Glucose Intolerance, Metabolic Syndrome

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Impaired Glucose Tolerance, Type 2 Diabetes and Metabolic Syndrome in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

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