TOPLINE:

Women with polycystic ovarian morphology (PCOM) showed higher rates of noninsulin-dependent diabetes (23.8% vs 9.3%) compared with those without PCOM over 37 years of follow-up. PCOM was associated with more severe metabolic disturbances at baseline but did not affect mortality or other chronic diseases.

METHODOLOGY:

• Researchers conducted a prospective cohort study from 1987 to 2005 with follow-up until 2024 at a single academic referral center; 340 women with polycystic ovary syndrome (PCOS) who had baseline sonographic data were included.
• Analysis divided participants into two groups: 189 women with PCOM (mean age, 28.03 ± 5.98 years) defined by ≥ 12 peripherally distributed 2-9 mm follicles and 151 women without PCOM (mean age, 32.57 ± 9.21 years).
• Outcome measures included all-cause mortality and chronic morbidity assessment covering diabetes, cardiovascular, neurologic, thyroid, respiratory, gastrointestinal, kidney, autoimmune, psychiatric, and cancer conditions.
• Investigators collected baseline demographics, hormone levels, and cardiovascular risk factors, analyzing outcomes using multivariate logistic regression adjusted for age, BMI, fasting insulin, lipids, and follow-up duration.

TAKEAWAY:

• Women with PCOM exhibited significantly higher baseline metabolic disturbances, including elevated BMI (27.20 ± 5.74 vs 25.31 ± 6.31; P = .004), fasting insulin (12.84 ± 9.83 vs 8.85 ± 6.33 μIU/mL; P < .001), and total cholesterol (167.57 ± 63.32 vs 147.1 ± 82.24 mg/dL; P = .01).
• Noninsulin-dependent diabetes was significantly more prevalent in the PCOM group (23.8% vs 9.3%; P < .001), with multivariate analysis confirming this association (adjusted odds ratio, 2.92; 95% CI, 1.06-2.82; P = .02).
• Mean follow-up duration differed between groups (33.7 ± 2.3 years for PCOM vs 35.1 ± 4.9 years for non-PCOM; P < .001), with no significant differences in mortality rates or age at death (54.3 ± 11.5 vs 70.8 ± 13.6 years; P = .08).
• According to the authors, while PCOM was associated with early metabolic abnormalities and increased risk for type 2 diabetes, it did not correlate with increased mortality or other chronic diseases.

IN PRACTICE:

“These findings underscore the need for targeted metabolic monitoring and preventive strategies in women with PCOS and PCOM, as persistence of this ovarian pattern was associated with increased long-term risk for type 2 diabetes but not with increased mortality or broader chronic disease burden,” the authors of the study wrote.

SOURCE:

This study was led by Nir Kugelman, MD, McGill University Endocrinology Clinic in Montreal, Quebec, Canada. It was published online on October 31 in JAMA Network Open.

LIMITATIONS:

This study faced several constraints, including a relatively small sample size and single-center design that may limit generalizability. The absence of race and ethnicity data, which were not routinely documented during enrollment, prevented assessment of phenotype-specific differences across racial and ethnic subgroups. Additionally, antral follicle count, ovarian volume, and stromal parameters were not consistently recorded, limiting the ability to compare specific sonographic features with hyperandrogenism.

DISCLOSURES:

The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.