Metabolic and polycystic ovary syndromes in indigenous South Asian women with previous gestational diabetes mellitus

Objective To determine the risk of metabolic syndrome (MS) and polycystic ovary syndrome (PCOS) in a cohort of indigenous South Asian women with a recent history of gestational diabetes mellitus (GDM). Design Case–control study. Setting Department of Obstetrics & Gynaecology, University of Colombo, Sri Lanka. Sample Two hundred and seventy‐four indigenous Sri Lankan women with previous GDM and 168 ethnically matched controls. Of these, 147 with previous GDM and 67 controls not taking hormonal contraception participated in an in‐depth endocrine study. Methods Assessing the prevalence of MS and PCOS based on clinical features, biochemistry and ovarian ultrasound examination at 3 years postpartum. Main outcome measures Prevalence of MS and PCOS. Results Women with previous GDM and controls were studied at a mean (range) of 34.6 (13.4–84.1) and 46.5 (17.5–78) months postpartum, respectively. Those with previous GDM had a larger mean ± 95% confidence interval waist circumference (90.9 ± 1.3 versus 81.2 ± 2.8 cm, P= 0.0004) and were more likely to have hypertension (17.6 versus 7.4%, P= 0.001), glucose intolerance (51.7 versus 10.4%, P= 0.00001), hypertriglyceridaemia (16.3 versus 5.9%, P= 0.02) and a lower level of high‐density lipoprotein (70 versus 56.7%, P= 0.04) than the controls. Of the women who had GDM, 72 (49%) had MS, 86 (58.5%) had polycystic ovaries and 59 (40%) had PCOS, significantly more than the control women—4 (6%), 9 (13%) and 2 (3%), respectively (P= 0.00001). Conclusions The prevalence of MS and PCOS in indigenous Sri Lankan women 3 years postpartum is significantly higher in those with previous GDM compared with ethnically matched controls. This confirms an association between GDM and subsequent PCOS and MS.