title: Evaluation of adverse outcome in young women with polycystic ovary syndrome versus matched, reference controls: a retrospective, observational study.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is associated with insulin resistance, hyperandrogenism, and dyslipidemia, but the effects of these disturbances on long-term health are not fully understood.
  
  
  OBJECTIVE
  Our aim was to determine the relative risk of type 2 diabetes, cancer, large-vessel disease (LVD), and all-cause mortality for women diagnosed with PCOS.
  
  
  METHODS
  Data were extracted from the General Practice Research Database, a longitudinal, anonymized research database derived from nearly 600 primary-care practices in the United Kingdom. Patients with a diagnosis of PCOS between 1990 and 2010 were selected. Patients were matched to two sets of controls. The first set was matched according to primary-care practice and age, and the second was also matched on body mass index. Primary outcome was first incident record of diabetes. Crude rates for diabetes were presented, and time to diabetes was analyzed using Cox proportional hazard models. Secondary outcomes (cancer, LVD, and mortality) were also modeled.
  
  
  RESULTS
  Of 53,303 identified with a diagnosis of PCOS, 21,740 (40.8%) met the eligibility criteria. Median follow-up was 4.7 yr (interquartile range = 2.0-8.6 yr) in those with PCOS and 5.8 yr (2.7-9.6) in the reference group. Crude rates of diabetes were 5.7 and 1.7 per 1000 patient-years for cases and controls, respectively. The corresponding adjusted hazard ratio was 3.015 (95% confidence interval = 2.733-3.327). Of cases matched by body mass index, crude rates of diabetes were 4.7 and 2.4 per 1000 patient-years, respectively. The corresponding adjusted hazard ratio was 1.752 (1.514-2.028). No significant difference in BMI-adjusted risk was evident for cancer, LVD, or all-cause mortality.
  
  
  CONCLUSIONS
  During this follow-up period, women with PCOS were not at increased risk of LVD, cancer, or death, but they had increased risk of type 2 diabetes.
authors: Institute of Primary Care, School of Medicine, Cardiff University, Cardiff CF14 4XN, United Kingdom.
authors: Christopher L
authors: CL
authors: Morgan
authors: Sara
authors: S
authors: Jenkins-Jones
authors: Craig J
authors: CJ
authors: Currie
authors: D Aled
authors: DA
authors: Rees
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011320:Primary Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002784:Cholesterol