Understanding pain in women with polyendocrine metabolic ovarian syndrome: health risks and treatment effectiveness
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, United States
- PCOS Challenge: The National Polycystic Ovary Syndrome Association, United States
- Department of Medicine, Sidney Kimmel Medicine College, Thomas Jefferson University, United States
Figures
Figure 1
Future health outcomes associated with PMOS and PMOS + Pain.
(A) Analysis pipeline to calculate relative risk ratios (RR) for future health outcomes in PMOS (green) and PMOS and Pain (blue) cohorts for the 103,675,738 women queried. STEP 1 shows the number of women in the case and controls for both the PMOS (green) and PMOS and Pain (blue) cohorts. STEP 2 shows the number of cases and controls after 1:1 propensity score matching. STEP 3 shows the different future health conditions that were considered for future health outcomes. STEP 4 shows that the final step is calculating the relative risk for the future health outcomes. Popout box is a schematic representing how events were indexed in TriNetX for both the PMOS (green) and PMOS and Pain (blue) cohorts. (B) Relative risk ratios (RR) (x-axis) for future health outcomes (y-axis) for both PMOS (green) and PMOS and Pain (blue) cohorts. Darker hued circles indicate RR, while lighter hued boxes indicate the 95% confidence intervals. The black dashed line is set 1 and is the threshold for RR, where >1 is increased RR and <1 is decreased RR.
Figure 2
Prevalence of PMOS, PMOS and Pain, and associated conditions.
(A) Bar plots show the prevalence (%) of overall PMOS (green) and PMOS and Pain (blue) stratified by 10-year age groups. The total number of women with PMOS is 576,876 and the total number of women with PMOS and Pain is 171,326. (B) Bar plots show the prevalence (%) (left y-axis) of different diseases associated with PMOS (green) and PMOS and Pain (blue) (x-axis). The purple line indicates the prevalence fold-change between the PMOS and PMOS and Pain cohorts (right y-axis).
Figure 3
Self-reported race-stratified relative risk ratios for future health outcomes.
(A) Self-reported race-stratified TriNetX relative risk ratio analysis pipeline for future health outcomes in PMOS and Pain cohorts. Colors represent different self-reported race groups: Asian (orange), Black or African American (yellow), Other (red), White (purple). (B) Relative risk ratios (RR) for future health outcomes (y-axis) stratified by self-reported race. Colors represent different self-reported race groups (x-axis): Asian (orange), Black or African American (yellow), Other (red), White (purple). Error bars represent the 95% confidence intervals. Significant differences between RR are represented by asterisks (*), where p-value ≤0.05 = *, p-value ≤0.005 = **, p-value ≤0.0005 = ***, and -value ≤0.00005 = ****. Red dashed line is set 1 and is the threshold for RR, where >1 is increased RR and <1 is decreased RR.
-
Figure 3—source data 1
This file contains the relative risk ratios (RR) and 95% confidence intervals for the race-stratified PMOS and Pain cohort compared to controls.
- https://cdn.elifesciences.org/articles/103875/elife-103875-fig3-data1-v1.docx
-
Figure 3—source data 2
This file contains the signficance values for future health RR differences between each self-reported race group combination with PMOS and Pain cohort compared to controls.
- https://cdn.elifesciences.org/articles/103875/elife-103875-fig3-data2-v1.docx
Figure 4
Prevalence of Pain for women with PMOS before and after medications.
(A) Schematic representing how the PMOS and medication events were indexed in TriNetX for both abdominal and pelvic pain and dysmenorrhea. (B) Prevalence (%) changes (y-axis) of pain for women with PMOS cohort before and after prescription of COCPs (yellow), metformin (purple), and spironolactone (orange) (x-axis). Analysis was done separately for abdominal and pelvic pain (solid lines) and dysmenorrhea (dashed lines).
Tables
Table 1
Inclusion and exclusion criteria for PMOS (top) and PMOS and Pain (bottom) cases and control cohorts.
| PMOS | No PMOS | |
|---|---|---|
| Inclusion | Female | Female |
| PCOS diagnosis (ICD 10 Code E28.2) | ||
| Irregular menstruation (ICD 10 Code N92.6) and hirsutism (ICD 10 Code L68.0) or irregular menstruation (ICD 10 Code N92.6) and androgen excess (ICD 10 Code) | ||
| Exclusion | Endometriosis (ICD 10 Code N80) | PCOS diagnosis (ICD 10 Code E28.2) |
| Uterine fibroids (ICD 10 Code D25, O34.1, O34.11, O34.10) | Irregular menstruation (ICD 10 Code N92.6) and hirsutism (ICD 10 Code L68.0) | |
| Polyp of corpus uteri (ICD 10 Code N84.0) | Irregular menstruation (ICD 10 Code N92.6) and androgen excess | |
| Pelvic inflammation (ICD 10 Code N73.9) | Endometriosis (ICD 10 Code N80), uterine fibroids (ICD 10 Code D25, O34.1), polyp of corpus uteri (ICD 10 Code N84.0), pelvic inflammation (ICD 10 Code N73.9), hypothyroidism (ICD 10 Code E03.8, E03.9), hyperprolactinemia (ICD 10 Code E22.1), adrenal hyperplasia (ICD 10 Code E27.8, Q89.1) | |
| PMOS and Pain | PMOS | |
| Inclusion | Female | Female |
| PCOS diagnosis (ICD 10 Code E28.2) | PCOS Diagnosis (ICD 10 Code E28.2) | |
| Irregular menstruation (ICD 10 Code N92.6) and hirsutism (ICD 10 Code L68.0) or irregular menstruation (ICD 10 Code N92.6) and androgen excess (ICD 10 Code) | Irregular menstruation (ICD 10 Code N92.6) and hirsutism (ICD 10 Code L68.0) or irregular menstruation (ICD 10 Code N92.6) and androgen excess (ICD 10 Code) | |
| Abdominal and pelvic pain (ICD Code 10 R10) or dysmenorrhea (ICD Code 10 N94.6) | ||
| Exclusion | Endometriosis (ICD 10 Code N80), uterine fibroids (ICD 10 Code D25, O34.1, O34.11, O34.10), hypothyroidism (ICD 10 Code E03.8, E03.9), pelvic inflammation (ICD 10 Code N73.9), hyperprolactinemia (ICD 10 Code E22.1), adrenal hyperplasia (ICD 10 Code E27.8, Q89.1), polyp of corpus uteri (ICD 10 Code N84.0) | Endometriosis (ICD 10 Code N80), uterine fibroids (ICD 10 Code D25, O34.1, O34.11, O34.10), hypothyroidism (ICD 10 Code E03.8, E03.9), pelvic inflammation (ICD 10 Code N73.9), hyperprolactinemia (ICD 10 Code E22.1), adrenal hyperplasia (ICD 10 Code E27.8, Q89.1), polyp of corpus uteri (ICD 10 Code N84.0) |
| Abdominal and pelvic pain (ICD Code 10 R10) or dysmenorrhea (ICD Code 10 N94.6) |
Table 2
Demographic results for PMOS case and control cohorts before and after 1:1 propensity score matching.
For each cohort analysis, cases were matched on the following criteria: age at the index event, self-reported race, overweight, obesity, and other hyperalimentation (ICD-10-CM E65-E69) status, type 2 diabetes mellitus (T2D) (ICD-10-CM E11) status, essential (primary) hypertension (ICD-10-CM I10) status, and hyperlipidemia, unspecified (ICD-10-CM E78.5) status. Baseline conditions were assessed up to 1 day before the index event.
| Before | After | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristic ID | Characteristic name | PMOS | % PMOS | No PMOS | % No PMOS | p-value | SD | PMOS | % PMOS | No PMOS | % No PMOS | p-value | SD |
| Total | 576,876 | 8168013 | 565,077 | 565,077 | |||||||||
| AI | Age at index | 28.13 (±9.04) | 43.31 (±20.07) | 28.15 (±9.03) | 28.16 (±9.04) | 2.86E-01 | 0.00201 | ||||||
| 1002–5 | American Indian or Alaska Native | 2843 | 0.50% | 22,878 | 0.29% | 0.00E+00 | 0.03479 | 2843 | 0.50% | 1692 | 0.30% | 0.00E+00 | 0.03222 |
| 2028–9 | Asian | 27,410 | 4.85% | 318,481 | 3.97% | 0.00E+00 | 0.04296 | 27,397 | 4.85% | 27,951 | 4.95% | 1.57E-02 | 0.00454 |
| 2054–5 | Black or African American | 74,376 | 13.15% | 940,271 | 11.71% | 0.00E+00 | 0.04380 | 74,335 | 13.16% | 74,972 | 13.27% | 7.68E-02 | 0.00333 |
| 2076–8 | Native Hawaiian or Other Pacific Islander | 2810 | 0.50% | 22,962 | 0.29% | 0.00E+00 | 0.03380 | 2810 | 0.50% | 1704 | 0.30% | 0.00E+00 | 0.03104 |
| 2131–1 | Other race | 35,155 | 6.22% | 386,380 | 4.81% | 0.00E+00 | 0.06161 | 35,070 | 6.21% | 34,717 | 6.14% | 1.68E-01 | 0.00260 |
| UNK | Unknown race | 91,101 | 16.11% | 1,792,170 | 22.31% | 0.00E+00 | 0.15797 | 91,100 | 16.12% | 92,810 | 16.42% | 1.31E-05 | 0.00820 |
| 2106–3 | White | 331,862 | 58.68% | 4,549,060 | 56.64% | 0.00E+00 | 0.04137 | 331,522 | 58.67% | 331,231 | 58.62% | 5.78E-01 | 0.00105 |
| Other | 131,909 | 23% | 2,224,390 | 28% | 131,823 | 23% | 130,923 | 23% | |||||
| 2186–5 | Not Hispanic or Latino | 356,042 | 62.95% | 4,273,952 | 53.21% | 0.00E+00 | 0.198447 | 355,745 | 62.96% | 315,837 | 55.89% | 0.00E+00 | 0.144199 |
| UN | Unknown ethnicity | 141,799 | 25.07% | 3,286,982 | 40.92% | 0.00E+00 | 0.341983 | 141,761 | 25.09% | 201,808 | 35.71% | 0.00E+00 | 0.232572 |
| 2135–2 | Hispanic or Latino | 67,716 | 11.97% | 471,268 | 5.87% | 0.00E+00 | 0.215461 | 67,571 | 11.96% | 47,432 | 8.39% | 0.00E+00 | 0.118087 |
| E65-E68 | Overweight, obesity, and other hyperalimentation | 92,042 | 16.28% | 718,866 | 8.95% | 0.00E+00 | 0.22199 | 91,562 | 16.20% | 91,393 | 16.17% | 6.66E-01 | 0.00081 |
| I10 | Essential (primary) hypertension | 33,561 | 5.93% | 1,233,003 | 15.35% | 0.00E+00 | 0.30898 | 33,554 | 5.94% | 33,531 | 5.93% | 9.27E-01 | 0.00017 |
| E11 | Type 2 diabetes mellitus | 19,880 | 3.52% | 442,620 | 5.51% | 0.00E+00 | 0.09624 | 19,847 | 3.51% | 20,462 | 3.62% | 1.81E-03 | 0.00587 |
| E78.5 | Hyperlipidemia, unspecified | 16,734 | 2.96% | 737,752 | 9.19% | 0.00E+00 | 0.26295 | 16,733 | 2.96% | 16,355 | 2.89% | 3.49E-02 | 0.00397 |
| R10 | Abdominal and pelvic pain | 100,807 | 17.82% | 1,122,832 | 13.98% | 0.00E+00 | 0.10530 | 100,661 | 17.81% | 99,781 | 17.66% | 3.02E-02 | 0.00408 |
| N94.6 | Dysmenorrhea, unspecified | 16,107 | 2.85% | 137,898 | 1.72% | 0.00E+00 | 0.07580 | 16,070 | 2.84% | 18,870 | 3.34% | 0.00E+00 | 0.02863 |
| N97 | Female infertility | 13,244 | 2.34% | 34,447 | 0.43% | 0.00E+00 | 0.16421 | 13,241 | 2.34% | 4333 | 0.77% | 0.00E+00 | 0.12767 |
| N83 | Noninflammatory disorders of ovary, fallopian tube and broad ligament | 22,160 | 3.92% | 138,266 | 1.72% | 0.00E+00 | 0.13300 | 22,144 | 3.92% | 15,098 | 2.67% | 0.00E+00 | 0.06989 |
| HS200 | Contraceptives, systemic | 84,147 | 14.88% | 651,819 | 8.12% | 0.00E+00 | 0.21324 | 84,076 | 14.88% | 91,954 | 16.27% | 0.00E+00 | 0.03845 |
| 6809 | Metformin | 38,551 | 6.82% | 260,773 | 3.25% | 0.00E+00 | 0.16386 | 38,506 | 6.81% | 14,589 | 2.58% | 0.00E+00 | 0.20104 |
| 9997 | Spironolactone | 17,819 | 3.15% | 103,247 | 1.29% | 0.00E+00 | 0.12691 | 17,813 | 3.15% | 7063 | 1.25% | 0.00E+00 | 0.12994 |
Table 3
Demographic and baseline characteristics for PMOS and Pain case and control cohorts before and after 1:1 propensity score matching.
For each cohort analysis, cases were matched on the following criteria: age at the index event, self-reported race, overweight, obesity, and other hyperalimentation (ICD-10-CM E65-E69) status, type 2 diabetes mellitus (T2D) (ICD-10-CM E11) status, essential (primary) hypertension (ICD-10-CM I10) status, and hyperlipidemia, unspecified (ICD-10-CM E78.5) status. Baseline conditions were assessed up to 1 day before the index event.
| Before | After | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristic ID | Characteristic name | PMOS +Pain | % PMOS +Pain | PMOS - Pain | % PMOS - Pain | p-value | SD | PMOS +Pain | % PMOS +Pain | PMOS - Pain | % PMOS - Pain | p-value | SD |
| Total | 171,326 | 410,515 | 164,744 | 164,744 | |||||||||
| AI | Age at index | 28.53 (±8.78) | 28.41 (±9.20) | 100% | 3.08E-06 | 0.0136 | 28.39 (±8.81) | 28.40 (±9.03) | 100% | 8.48E-01 | 0.00067 | ||
| 1002–5 | American Indian or Alaska Native | 950 | 0.56% | 1931 | 0.48% | 1.34E-04 | 0.0109 | 933 | 0.57% | 740 | 0.45% | 2.24E-06 | 0.01649 |
| 2028–9 | Asian | 6075 | 3.58% | 21,499 | 5.36% | 0.00E+00 | 0.0862 | 6044 | 3.67% | 5969 | 3.63% | 4.86E-01 | 0.00243 |
| 2054–5 | Black or African American | 24,692 | 14.55% | 50,827 | 12.67% | 0.00E+00 | 0.0548 | 23,657 | 14.37% | 25,050 | 15.21% | 8.05E-12 | 0.02383 |
| 2076–8 | Native Hawaiian or Other Pacific Islander | 937 | 0.55% | 1927 | 0.48% | 4.57E-04 | 0.0100 | 928 | 0.56% | 756 | 0.46% | 2.64E-05 | 0.01465 |
| 2131–1 | Other race | 10,935 | 6.44% | 24,595 | 6.13% | 8.34E-06 | 0.0128 | 10,637 | 6.46% | 10,595 | 6.43% | 7.66E-01 | 0.00104 |
| UNK | Unknown race | 22,174 | 13.06% | 69,034 | 17.21% | 0.00E+00 | 0.1158 | 22,043 | 13.39% | 22,107 | 13.43% | 7.43E-01 | 0.00114 |
| 2106–3 | White | 104,003 | 61.26% | 231,439 | 57.68% | 0.00E+00 | 0.0730 | 100,428 | 60.99% | 99,453 | 60.40% | 5.04E-04 | 0.01212 |
| Other | 34,996 | 21% | 97,487 | 24% | 34,541 | 21% | 34,198 | 21% | |||||
| 2186–5 | Not Hispanic or Latino | 109,689 | 64.59% | 250,682 | 62.40% | 0 | 0.045 | 105,912 | 64.29% | 106,378 | 64.57% | 0.08991917 | 0.0059 |
| UN | Unknown ethnicity | 36,480 | 21.48% | 106,152 | 26.43% | 0 | 0.116 | 35,807 | 21.74% | 38,637 | 23.45% | 4.4381E-32 | 0.0411 |
| 2135–2 | Hispanic or Latino | 23,662 | 13.93% | 44,881 | 11.17% | 0 | 0.083 | 23,025 | 13.98% | 19,729 | 11.98% | 0 | 0.0596 |
| E65-E68 | Overweight, obesity, and other hyperalimentation | 57,508 | 33.88% | 58,705 | 14.63% | 0.00E+00 | 0.4608 | 52,443 | 31.85% | 52,512 | 31.89% | 7.96E-01 | 0.00090 |
| I10 | Essential (primary) hypertension | 21,094 | 12.43% | 20,962 | 5.22% | 0.00E+00 | 0.2559 | 17,411 | 10.57% | 17,868 | 10.85% | 1.00E-02 | 0.00897 |
| E11 | Type 2 diabetes mellitus | 13,316 | 7.84% | 12,421 | 3.10% | 0.00E+00 | 0.2100 | 10,826 | 6.57% | 10,529 | 6.39% | 3.56E-02 | 0.00732 |
| E78.5 | Hyperlipidemia, unspecified | 12,548 | 7.39% | 10,765 | 2.68% | 0.00E+00 | 0.2165 | 9994 | 6.07% | 9648 | 5.86% | 1.09E-02 | 0.00887 |
| R10 | Abdominal and pelvic pain | 73,588 | 43.35% | 38,148 | 9.51% | 0.00E+00 | 0.8310 | 71,136 | 43.20% | 20,710 | 12.58% | 0.00E+00 | 0.72651 |
| N94.6 | Dysmenorrhea, unspecified | 12,010 | 7.07% | 5391 | 1.34% | 0.00E+00 | 0.2884 | 11,704 | 7.11% | 2977 | 1.81% | 0.00E+00 | 0.25894 |
| N97 | Female infertility | 10,047 | 5.92% | 9443 | 2.35% | 0.00E+00 | 0.1798 | 9689 | 5.88% | 4305 | 2.61% | 0.00E+00 | 0.16263 |
| N83 | Noninflammatory disorders of ovary, fallopian tube, and broad ligament | 18,080 | 10.65% | 9851 | 2.46% | 0.00E+00 | 0.3358 | 17,401 | 10.57% | 5146 | 3.13% | 0.00E+00 | 0.29795 |
| HS200 | Contraceptives, systemic | 50,158 | 29.55% | 54,520 | 13.59% | 0.00E+00 | 0.3955 | 48,365 | 29.37% | 26,568 | 16.13% | 0.00E+00 | 0.31975 |
| 6809 | Metformin | 29,039 | 17.11% | 26,583 | 6.63% | 0.00E+00 | 0.3284 | 26,679 | 16.20% | 14735 | 8.95% | 0.00E+00 | 0.22008 |
| 9997 | Spironolactone | 12,536 | 7.38% | 12,620 | 3.15% | 0.00E+00 | 0.1907 | 11,780 | 7.15% | 5889 | 3.58% | 0.00E+00 | 0.15927 |
Table 4
Counts and prevalence (%) of PMOS and Pain cases and controls (PMOS without Pain) for self-reported race groups.
| Self-reported race group | PMOS + Pain | PMOS - Pain | Prevalence (%) |
|---|---|---|---|
| Asian | 6,075 | 21,499 | 22.03 |
| Black or African American | 24,692 | 50,827 | 32.70 |
| Other | 34,996 | 97,487 | 26.42 |
| White | 104,003 | 231,439 | 31.00 |
Table 5
Relative risk ratios (RR) for PMOS and PMOS and Pain cases and control cohorts.
Significant differences in RR between PMOS and PMOS and Pain cohorts are bolded.
| Outcomes | Cohort name | Patients in cohort | Patients with outcome | Risk (%) | Relative risk ratio (RR) | 95% CI (lower) | 95% CI (upper) | p-Value |
|---|---|---|---|---|---|---|---|---|
| Abdominal and pelvic pain | PMOS + pain | 0 | 0 | NA | NA | NA | NA | |
| Abdominal and pelvic pain | PMOS - pain | 141,399 | 13,599 | 9.6 | ||||
| Abdominal and pelvic pain | PMOS overall | 412,548 | 86,597 | 21.0 | 1.15 | 1.14 | 1.16 | |
| Abdominal and pelvic pain | PMOS controls | 434,896 | 79,269 | 18.2 | ||||
| Acute pharyngitis | PMOS + pain | 129,728 | 17,522 | 13.5 | 1.62 | 1.58 | 1.65 | 1.64e-397 |
| Acute pharyngitis | PMOS - pain | 144,688 | 12,096 | 8.4 | ||||
| Acute pharyngitis | PMOS overall | 499,241 | 52,252 | 10.5 | 0.85 | 0.84 | 0.86 | |
| Acute pharyngitis | PMOS controls | 478,551 | 58,938 | 12.3 | ||||
| Anxiety | PMOS + pain | 110,687 | 22,193 | 20.1 | 1.37 | 1.35 | 1.39 | 2.33E-11 |
| Anxiety | PMOS - pain | 127,316 | 18,631 | 14.6 | ||||
| Anxiety | PMOS overall | 446,953 | 76,641 | 17.1 | 1.11 | 1.10 | 1.12 | |
| Anxiety | PMOS controls | 446,119 | 68,745 | 15.4 | ||||
| Depression | PMOS + pain | 124,618 | 17,015 | 13.7 | 1.43 | 1.40 | 1.47 | 1.72E-05 |
| Depression | PMOS - pain | 137,978 | 13,136 | 9.5 | ||||
| Depression | PMOS overall | 480,632 | 55,085 | 11.5 | 1.23 | 1.21 | 1.24 | |
| Depression | PMOS controls | 487,289 | 45,485 | 9.3 | ||||
| Essential hypertension | PMOS + pain | 143,081 | 11,675 | 8.2 | 1.19 | 1.16 | 1.22 | 4.96E-56 |
| Essential hypertension | PMOS - pain | 140,519 | 9611 | 6.8 | ||||
| Essential hypertension | PMOS overall | 507,320 | 39,064 | 7.7 | 1.55 | 1.52 | 1.57 | |
| Essential hypertension | PMOS controls | 522,019 | 25,971 | 5.0 | ||||
| GERD | PMOS + pain | 130,549 | 17,386 | 13.3 | 1.80 | 1.76 | 1.84 | 2.52E-48 |
| GERD | PMOS - pain | 147,029 | 10,873 | 7.4 | ||||
| GERD | PMOS overall | 506,269 | 50,438 | 10.0 | 1.32 | 1.30 | 1.33 | |
| GERD | PMOS controls | 516,304 | 39,041 | 7.6 | ||||
| Infertility | PMOS + pain | 164,744 | 9358 | 5.7 | 1.04 | 1.01 | 1.07 | 6.04e-820 |
| Infertility | PMOS - pain | 164,744 | 9005 | 5.5 | ||||
| Infertility | PMOS overall | 530,186 | 22,014 | 4.2 | 3.55 | 3.45 | 3.64 | |
| Infertility | PMOS controls | 559,224 | 6548 | 1.2 | ||||
| Kidney disease | PMOS + pain | 163,279 | 1409 | 0.9 | 1.35 | 1.24 | 1.46 | 6.64E-02 |
| Kidney disease | PMOS - pain | 163,529 | 1047 | 0.6 | ||||
| Kidney disease | PMOS overall | 561,790 | 3884 | 0.7 | 1.23 | 1.18 | 1.29 | |
| Kidney disease | PMOS controls | 561,941 | 3148 | 0.6 | ||||
| Liver disease | PMOS + pain | 153,385 | 8287 | 5.4 | 1.88 | 1.82 | 1.95 | 1.35E-23 |
| Liver disease | PMOS - pain | 159,449 | 4576 | 2.9 | ||||
| Liver disease | PMOS overall | 548,043 | 21,676 | 4.0 | 2.25 | 2.20 | 2.30 | |
| Liver disease | PMOS controls | 557,915 | 9806 | 1.8 | ||||
| Obesity | PMOS + pain | 99,165 | 20,223 | 20.4 | 1.11 | 1.09 | 1.13 | 2.07e-506 |
| Obesity | PMOS - pain | 92,475 | 17,003 | 18.4 | ||||
| Obesity | PMOS overall | 391,393 | 80,997 | 20.7 | 2.00 | 1.98 | 2.03 | |
| Obesity | PMOS controls | 444,137 | 45,849 | 10.3 | ||||
| Ovarian cysts | PMOS +pain | 138,617 | 10,601 | 7.6 | 2.23 | 2.16 | 2.30 | 2.24E-36 |
| Ovarian cysts | PMOS - pain | 156,505 | 5379 | 3.4 | ||||
| Ovarian cysts | PMOS overall | 527,152 | 29,047 | 5.5 | 1.56 | 1.53 | 1.59 | |
| Ovarian cysts | PMOS controls | 547,043 | 19,347 | 3.5 | ||||
| T2D | PMOS +Pain | 150,919 | 7882 | 5.2 | 1.12 | 1.08 | 1.15 | 4.28e-453 |
| T2D | PMOS - Pain | 149,586 | 6989 | 4.7 | ||||
| T2D | PMOS Overall | 528,769 | 27,124 | 5.1 | 2.77 | 2.71 | 2.84 | |
| T2D | PMOS Controls | 541,299 | 10,018 | 1.9 |
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Understanding pain in women with polyendocrine metabolic ovarian syndrome: health risks and treatment effectiveness
eLife 14:RP103875.
https://doi.org/10.7554/eLife.103875.3
