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PCOS Prevalent in 1-in-5 Girls with Pediatric Type 2 Diabetes

A systematic review and meta-analysis suggest approximately 20% of girls with type 2 diabetes also had polycystic ovary syndrome.

Results of a systematic review and meta-analysis are providing clinicians with an overview of the prevalence of polycystic ovary syndrome (PCOS) among girls with pediatric type 2 diabetes.

Results of the study, which included data from 6 studies involving 470 girls with type 2 diabetes, suggested approximately 1 in 5 girls with type 2 diabetes had PCOS, but investigators noted further investigation is needed to identify at-risk groups and develop management strategies.

“Identifying PCOS in this population is critical to allow for early screening and management of PCOS and its associated health concerns. Future studies are urgently needed to define the impact of obesity and race on PCOS prevalence in this population and to ensure the development of personalized assessment and treatment strategies,” wrote investigators.

Already the most common endocrine condition impacting girls of reproductive age, data suggests the prevalence of PCOS is only expected to grow in coming years. With the prevalence of type 2 diabetes also expected to grow, investigators sought to provide colleagues and other clinicians with an overview of the prevalence of PCOS in girls with type 2 diabetes through a systematic review and meta-analysis of studies within the MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science: Conference Proceedings Citation Index–Science, and the gray literature Web of Science: Conference Proceedings Citation Index–Science, and the gray literature from inception through April 4, 2021.

For inclusion in the current study, literature of interest needed to report PCOS in girls diagnosed with type 2 diabetes, included at least 10 patients, and be either cross-sectional, retrospective, and prospective cohort studies. Investigators noted all studies reporting incidence of PCOS were included, regardless of whether they reported how PCOS was defined.

A total of 722 articles underwent screening. Of these, 6 studies with a population of 470 girls met inclusion criteria. Of the 6, 5 were retrospective cohort studies and 1 was a prospective cohort study. Investigators noted the mean age at diagnosis of type 2 diabetes in the studies ranged from 12.9-16.1 years and the mean duration of diabetes among the studies ranged from inclusion at diagnosis to 5.9 years after initial diagnosis.

Upon analysis, the overall prevalence of PCOS across the studies was 19.58% (95% CI, 12.02-27.14), with heterogeneity of moderate to high (I2=74%; P=.002). In a sensitivity analysis of studies that included PCOS diagnostic criteria, the pooled PCOS prevalence was 24.04% (95% CI, 15.07-33.01) with substantial reduction in heterogeneity (I2=0%; P=.92).

Despite an initial intent of assessing the impact of obesity on these associations, but none of the studies included provided information related to prevalence of obesity. When assessing the prevalence of PCOS by race, only 2 studies reporting this information were identified. In these studies, the prevalence was 17.00% in White individuals, 23.10% in Indian individuals, and 2.00% in Indigenous individuals in Canada.

“Health-related quality of life is substantially reduced in patients with PCOS, with bodyweight concerns, menstrual irregularity, and a sense of lack of control over health being important contributors. It is critical that PCOS in T2D is managed with a focus on biopsychosocial well-being to achieve positive health outcomes,” wrote investigators.

This study, “Prevalence of Polycystic Ovary Syndrome in Patients With Pediatric Type 2 Diabetes,” was published in JAMA Network Open.