Polycystic ovary syndrome with metabolic syndrome and diabetes: a systematic review and meta-analysis
6 affiliations
- 1Department of Nursing and Midwifery, Sa.C., Islamic Azad University, Sanandaj, Iran
- 2Young Reaserchers and Elite Club, Sa.C., Islamic Azad University, Sanandaj, Iran
- 3Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan Iran
- 4Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Hamedan University of Medical Sciences, Hamedan, Iran
- 5Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- 6Health Metrics and Evaluation Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract
Purpose: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder linked to metabolic complications. This study systematically reviewed and meta-analyzed the association between PCOS and the risk of Metabolic Syndrome and Diabetes Mellitus.
Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL for studies published between 1990 and 2025, following PRISMA guidelines. Observational studies (cross-sectional, case-control, cohort) diagnosing PCOS by Rotterdam, NIH, or AES criteria were included. Data extraction used a standardized checklist, and study quality was assessed with the Newcastle-Ottawa Scale. Pooled relative risks (RR) were calculated using the DerSimonian-Laird random-effects model. Heterogeneity was evaluated with Cochrane Q and I², and subgroup analyses explored variations.
Results: From 3,747 articles, 44 studies (54 effect sizes) on DM and six on MetS were included. Women with PCOS had a 72% higher risk of DM (RR: 1.72, 95% CI: 1.43–2.06), strongest with Rotterdam criteria (RR: 1.86). Risk was highest for gestational DM (RR: 2.05) and in women > 40 years (RR: 1.88). For MetS, PCOS increased risk by 48% (RR: 1.48, 95% CI: 1.15–1.90), strongest with NIH criteria (RR: 3.41). Geographic differences showed higher DM risk in Europe (RR: 1.97) and MetS in Asia (RR: 1.99). Heterogeneity was substantial, but no publication bias was detected.
Conclusion: PCOS significantly elevates risks of DM and MetS, influenced by diagnostic criteria, age, BMI, and geography. Standardized diagnostic approaches and longitudinal studies are essential to refine risk assessment and guide targeted interventions.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13048-026-02219-2.
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BibTeX
@article{pourahmad2026polycystic,
title = {{Polycystic ovary syndrome with metabolic syndrome and diabetes: a systematic review and meta-analysis}},
author = {Bita Pourahmad and Mostafa Majidnia and Nadia Saniee and Sevda Riyahifar and Yousef Moradi},
journal = {Journal of Ovarian Research},
year = {2026},
month = jul,
doi = {10.1186/s13048-026-02219-2},
url = {https://doi.org/10.1186/s13048-026-02219-2},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Polycystic ovary syndrome with metabolic syndrome and diabetes: a systematic review and meta-analysis
AU - Bita Pourahmad
AU - Mostafa Majidnia
AU - Nadia Saniee
AU - Sevda Riyahifar
AU - Yousef Moradi
PY - 2026
DA - 2026/07/30
JO - Journal of Ovarian Research
DO - 10.1186/s13048-026-02219-2
UR - https://doi.org/10.1186/s13048-026-02219-2
AB - Purpose: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder linked to metabolic complications. This study systematically reviewed and meta-analyzed the association between PCOS and the risk of Metabolic Syndrome and Diabetes Mellitus. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL for studies published between 1990 and 2025, following PRISMA guidelines. Observational studies (cross-sectional, case-control, cohort) diagnosing PCOS by Rotterdam, NIH, or AES criteria were included. Data extraction used a standardized checklist, and study quality was assessed with the Newcastle-Ottawa Scale. Pooled relative risks (RR) were calculated using the DerSimonian-Laird random-effects model. Heterogeneity was evaluated with Cochrane Q and I², and subgroup analyses explored variations. Results: From 3,747 articles, 44 studies (54 effect sizes) on DM and six on MetS were included. Women with PCOS had a 72% higher risk of DM (RR: 1.72, 95% CI: 1.43–2.06), strongest with Rotterdam criteria (RR: 1.86). Risk was highest for gestational DM (RR: 2.05) and in women > 40 years (RR: 1.88). For MetS, PCOS increased risk by 48% (RR: 1.48, 95% CI: 1.15–1.90), strongest with NIH criteria (RR: 3.41). Geographic differences showed higher DM risk in Europe (RR: 1.97) and MetS in Asia (RR: 1.99). Heterogeneity was substantial, but no publication bias was detected. Conclusion: PCOS significantly elevates risks of DM and MetS, influenced by diagnostic criteria, age, BMI, and geography. Standardized diagnostic approaches and longitudinal studies are essential to refine risk assessment and guide targeted interventions. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13048-026-02219-2.
SN - 1757-2215
ER -