Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype
2017
Background Women with polycystic ovarian syndrome have a high prevalence of
metabolic syndromeand type 2 diabetes mellitus. Blacks and
Hispanicshave a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since
metabolic syndromeis a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in
metabolic syndromeamong women with polycystic ovarian syndrome is important for prevention strategies. However, data regarding racial/ethnic differences in metabolic phenotype among women with polycystic ovary syndrome are inconsistent. Objective We sought to determine if there are racial/ethnic differences in insulin resistance,
metabolic syndrome, and hyperandrogenemia in women with polycystic ovarian syndrome. Study Design We conducted secondary data analysis of a prospective multicenter, double-blind controlled clinical trial, the Pregnancy in Polycystic Ovary Syndrome II study, conducted in 11 academic health centers. Data on 702 women with polycystic ovarian syndrome aged 18-40 years who met modified Rotterdam criteria for the syndrome and wished to conceive were included in the study. Women were grouped into racial/ethnic categories:
non-Hispanic whites, non-
Hispanicblacks, and
Hispanic. The main outcomes were the prevalence of insulin resistance,
metabolic syndrome, and hyperandrogenemia in the different racial/ethnic groups. Results Body mass index (35.1 ± 9.8 vs 35.7 ± 7.9 vs 36.4 ± 7.9 kg/m 2 ) and waist circumference (106.5 ± 21.6 vs 104.9 ± 16.4 vs 108.7 ± 7.3 cm) did not differ significantly between
non-Hispanic white, non-
Hispanicblack, and
Hispanicwomen.
Hispanicwomen with polycystic ovarian syndrome had a significantly higher prevalence of
hirsutism(93.8% vs 86.8%), abnormal
free androgen index(75.8% vs 56.5%), abnormal homeostasis model assessment (52.3% vs 38.4%), and hyperglycemia (14.8% vs 6.5%), as well as lower
sex hormone binding globulincompared to
non-Hispanic whites. Non-
Hispanicblack women had a significantly lower prevalence of
metabolic syndrome(24.5% vs 42.2%) compared with
Hispanicwomen, and lower serum triglyceride levels compared to both
Hispanicsand
non-Hispanic whites(85.7 ± 37.3 vs 130.2 ± 57.0 vs 120.1 ± 60.5 mg/dL, P P Conclusion
Hispanicwomen with polycystic ovarian syndrome have the most severe phenotype, both in terms of
hyperandrogenismand metabolic criteria. Non-
Hispanicblack women have an overall milder polycystic ovarian syndrome phenotype than
Hispanicsand in some respects, than
non-Hispanic whitewomen.
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