Polycystic Ovary Syndrome (PCOS/PMOS) in Type 1 Diabetes Mellitus: a cross-sectional study of 785 patients and 1152 controls

Context

Little is known about the association between polycystic ovary syndrome (PCOS), or as it has been renamed, polyendocrine metabolic ovarian syndrome (PMOS), and type 1 diabetes (T1D).

Objective

To study the prevalence of PMOS in a large T1D population compared to controls, and clinical and hormonal features of this cohort.

Design

A two-step cross-sectional study, investigating self-reported symptoms and prevalence of PMOS in women with T1D and controls, followed by clinical assessment in those

with suspected PMOS.

Patients and Controls

785 women with T1D and 1152 population-based controls were included in the questionnaire part, of which 102 women with T1D and 97 controls participated in the clinical examination.

Main Outcome

The primary outcome was the self-reported prevalence of PMOS, defined as either a physician diagnosis or the prevalence of ovulatory dysfunction in combination with hirsutism.

Results

A greater proportion of women with T1D than controls reported either a prior diagnosis of PMOS or presence of both ovulatory dysfunction and hirsutism, resulting in a pooled PMOS prevalence of 10.7% in T1D vs 6.7% in controls (OR =  1.7 95% CI: 1.1- 2.5). Among those who underwent more extensive testing and had a clinically confirmed PMOS diagnosis, the T1D group had higher serum androgens than the controls, but similar levels of free androgen index and comparable PMOS symptoms.

Conclusions

The prevalence of PMOS is increased in T1D compared to population-based controls. Women with T1D and PMOS have higher levels of androgens compared to controls with PMOS, indicating a T1D specific PMOS phenotype.