Polycystic Ovary Syndrome and Vascular Damage Among Women with Type 1 Diabetes in the SEARCH for Diabetes in Youth Cohort

Aims:Polycystic ovary syndrome (PCOS) may confer increased risk for cardiovascular disease (CVD) and may also be common among women with type 1 diabetes. We examined whether PCOS confers increased risk of vascular damage among women with type 1 diabetes. Methods:Participants (n = 853) included women with type 1 diabetes enrolled in SEARCH, a large prospective population-based study of diabetes in youth, who underwent at least one assessment of arterial stiffness and responded to questions about a physician diagnosis of PCOS at approximately 17 years of age and again at approximately 22 years of age. Using generalized estimating equations, which accounted for repeated measures, we examined whether PCOS was associated with higher odds of arterial stiffness before and after adjustment for cardiovascular risk factors. Results:Among women with type 1 diabetes, arterial stiffness was more frequent among those reporting a physician diagnosis of PCOS versus those without a physician diagnosis of PCOS (24.4% vs. 7.9%, p = 0.0001). After adjustment for cardiovascular risk factors, including age, race/ethnicity, diabetes duration, waist circumference, mean arterial pressure, and cigarette use, PCOS remained strongly associated with arterial stiffness (odds ratio: 2.08, 95% confidence interval: 1.09, 3.99). Conclusions:In a large cohort of youth-onset type 1 diabetes, arterial stiffness is observed as early as the 3rd decade of life among women, placing them at risk for premature CVD. Women with type 1 diabetes and PCOS have greater risk of vascular damage compared to women with type 1 diabetes who do not have PCOS.