UK: The use of combined oral contraceptive pills (COCP) in women with polycystic ovary syndrome (PCOS) reduces the risk of dysglycemia regardless of their body mass index, a recent study has suggested. The findings, published in the journal Diabetes Care, support "the recommendation that women with PCOS should be screened for type 2 diabetes irrespective of bodyweight category.
Irregular menstrual cycles are related to increased cardiovascular mortality. PCOS is a hormonal disorder characterized by irregular menses and androgen excess. Androgens are known to increase metabolic risk in PCOS women. COCPs are used in PCOS both to reduce the biologically active androgen fraction and for cycle regulation.
Against the above background, Balachandran Kumarendran, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, U.K, and colleagues aimed to examine COCP use and risk of dysglycemia (prediabetes and type 2 diabetes) in women with PCOS.
For this purpose, the researchers carried out a retrospective population-based cohort study using a large U.K. primary care database (The Health Improvement Network [THIN]; 3.7 million patients from 787 practices). They determined dysglycemia risk (64,051 women with PCOS and 123,545 matched control subjects), as well as a nested pharmacoepidemiological case-control study to investigate COCP use in relation to dysglycemia risk (2,407 women with PCOS with [case subjects] and without [control subjects] a diagnosis of dysglycemia during follow-up).
Key findings include:
The adjusted hazard ratio for dysglycemia in women with PCOS was 1.87 (adjusting for age, social deprivation, BMI, ethnicity, and smoking), with increased rates of dysglycemia in all BMI subgroups.
Women with PCOS and COCP use had a reduced dysglycemia risk (aOR 0.72).
"The study, however, is limited by its retrospective nature and the use of routinely collected electronic general practice record data, which does not allow for the exclusion of the impact of prescription-by-indication bias," the authors wrote.
Future prospective studies should be considered for further understanding of these observations and potential causality, they concluded.
Reference:
Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study. Balachandran Kumarendran, Michael W. O'Reilly, Anuradhaa Subramanian, Dana Šumilo, Konstantinos Toulis, Krishna M. Gokhale, Chandrika N. Wijeratne, Arri Coomarasamy, Abd A. Tahrani, Laurent Azoulay, Wiebke Arlt, Krishnarajah Nirantharakumar. Diabetes Care Oct 2021, dc210437; DOI: 10.2337/dc21-0437