年輕多囊性卵巢症候群患者有較高第二型糖尿病風險：全國人口之回溯性世代研究

Higher Risk of Type 2 Diabetes in Young Women with polycystic ovary syndrome: A Nationwide, Population-Based, Retrospective Cohort Study

廖婉婷(Wan-Ting Liao)

指導教授 ： 吳俊錡

中山醫學大學/醫學院/醫學研究所/博士(2023年)

https://doi.org/10.6834/csmu202300032

摘要

背景
多囊性卵巢症候群是一種常見疾患，估計發生在全世界5-10％的育齡婦女。它可能導致多種症狀，例如生殖，代謝和情緒障礙。多囊性卵巢症候群的症狀很複雜。學術界已經明確表明，患有多囊性卵巢症候群的婦女的胰島素阻抗比例更高，並且預計將來患第二型糖尿病的風險也會增加。這項研究旨在評估與沒有罹患多囊性卵巢症候群的正常女性做對照相比，患有多囊性卵巢症候群的女性隨著時間推移第二型糖尿病的發生率。
材料和方法
在這項基於人口的回溯性研究中，我們使用了縱向健康保險數據庫2000（LHID2000）中的個人數據來評估我們的結果。 LHID2000是全民健康保險研究數據庫（NHIRD）的子集，包含從NHIRD的2000年受益人登記冊（ID）中隨機抽取的1,000,000個人的所有原始保險理賠數據。我們自1997-2010年挑選了新診斷為多囊性卵巢症候群的2545名女性。對照組則隨機選擇無多囊性卵巢症候群的女性，並按年齡，起始日，和合併症與實驗組進行1：1匹配。 
結論
校正年齡與共病變量後，多囊性卵巢症候群組中第二型糖尿病的發生率高於對照組（HR = 5.13，95％CI = 3.51-7.48，p <0.0001）。 多囊性卵巢症候群組顯示18-24歲年齡組的第二型糖尿病發生率顯著更高（HR = 10.4，95％CI = 5.04-21.4，p <0.0001）。第二型糖尿病的發生率隨著診斷時患者年齡的增加而降低。我們的研究表明，患有多囊性卵巢症候群的女性將來可能比非多囊性卵巢症候群的女性罹患第二型糖尿病的風險高，且在年輕族群上風險更高。

關鍵字

多囊性卵巢症候群 ； 第二型糖尿病 ； 代謝紊亂

並列摘要

Background
Polycystic ovary syndrome (PCOS) is a common condition in human beings, affecting 5-10% of women of reproductive age worldwide. It might lead to a variety of syndrome such as reproductive, metabolic and mood disorders. The symptoms of PCOS are complex. The academic circles had made it clear that women with polycystic ovary syndrome have a higher proportion of insulin resistance and are expected to have an increased risk of developing type 2 diabetes(T2DM) in the future. This study aimed to evaluate the incidence of T2DM over time in women with PCOS, in comparison with non-PCOS controls.
Materials and Methods
In this population-based retrospective cohort study, we used data from individuals in Longitudinal Health Insurance Database 2000(LHID2000) to evaluate our outcomes. LHID2000 is a subset of National Health Insurance Research Database (NHIRD), contains all the original claim data of 1,000,000 individuals randomly sampled from the 2000 Registry for Beneficiaries (ID) of the NHIRD. We identified 2545 eligible patients who were newly diagnosed with PCOS in 1997-2010. For the compared cohort group, women without PCOS was randomly selected and 1:1 frequency matched to the cohort group by age, index days and comorbidities.
Conclusion
After adjustment for potential confounding variables, the incidence of T2DM was higher among PCOS group compared with control group (HR = 5.13, 95% CI = 3.51–7.48, p < 0.0001). The PCOS group showed a significantly higher incidence of T2DM in 18-24 age group (HR = 10.4, 95% CI = 5.04–21.4, p < 0.0001). The incidence of T2DM decreased with the increasing age of the patients at diagnosis. Our study suggests that younger women with PCOS may suffer higher risk of developing T2DM in the future than non-PCOS women.

並列關鍵字

Polycystic ovary syndrome ； Type 2 Diabetes Mellitus ； Metabolic disorder

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