Prevalence and predictors of metabolic abnormalities in Chinese women with PCOS: a cross- sectional study

Abstract

BackgroundPolycystic ovary syndrome (PCOS) is a common condition estimated to affect 5.61% of Chinese women of reproductive age, but little is known about the prevalence and predictors in Chinese PCOS patients. This study aimed to determine the prevalence and predictors of the metabolic abnormalities in Chinese women with and without PCOS.MethodsA large-scale national epidemiological investigation was conducted in reproductive age women (19 to 45 years) across China. 833 reproductive aged PCOS women, who participated in the healthcare screening, were recruited from ten provinces in China. Clinical history, ultrasonographic exam (ovarian follicle), hormonal and metabolic parameters were the main outcome measures.ResultsThe prevalence of metabolic syndrome (MetS) as compared in PCOS and non-PCOS women from community were 18.2% vs 14.7%, and IR (insulin resistance) were 14.2% vs 9.3% (p < 0.001) respectively. After adjusting for age, the indicators (central obesity, hypertension, fasting insulin, SHBG, dyslipinaemia) for metabolic disturbances were significantly higher in PCOS than in non-PCOS groups. Using multivariate logistic regression, central obesity and FAI were risk factors, while SHBG was a protective factor on the occurrence of Mets and IR in PCOS women (OR: 1.132, 1.105 and 0.995).ConclusionsThe risk factors of the metabolic syndrome and insulin resistance were BMI and FAI for PCOS women, respectively. The decrease of SHBG level was also a risk factor for insulin resistance in both PCOS and metabolic disturbance.

Prevalence and degree of insulin resistance in Chinese Han women with PCOS: Results from euglycemic‐hyperinsulinemic clamps

“…Same as in previous studies, [25][26][27] the present study showed that the average BMI in Chinese patients with PCOS was within the normal range (23.2 kg/m 2 ) and that up to 64.5% were lean.…”

“…Ascaso et al selected the 75thpercentile of HOMA-IR value, which was 2.5 in Spaniards, with normal glucose regulation as the cutoff point to define IR35 In the same way, Xing et al showed that the 75th percentile of HOMA-IR values was 2.69 in Chinese with normal glucose regulation 23. Thus, 14.2% of Chinese women with PCOS had IR according to HOMA-IR > 2.69,27 while up to 86.3% of Arab women with PCOS had IR according to HOMA-IR > 2.5 15. The present study in Chinese Han women with PCOS showed that the prevalence of IR by euglycemic-hyperinsulinemic clamp was almost 3 folds higher compared with the prevalence of IR when determined by HOMA.…”

Luteinizing hormone/chorionic gonadotrophin receptor overexpressed in granulosa cells from polycystic ovary syndrome ovaries is functionally active

“…The increase in insulin levels has also been shown to up-regulate FSH induced LHCGR expression in murine GCs (Eppig et al, 1998). However, although hyperinsulinaemia tends to be present in PCOS women with hirsutism and obesity (Moran and Teede, 2009), the majority of women with PCOS have normal insulin levels (Li et al, 2014). Further research is necessary into the endocrine and paracrine regulation of LHCGR expression in women, including the role of growth factors and steroid hormones.…”

Paternal history of diabetes mellitus and hypertension affects the prevalence and phenotype of PCOS

“…SHBG was significantly lower in the positive paternal history group. SHBG is a protective factor, and a low level of SHBG might serve as a critical factor during the pathogenesis of PCOS and MetS [27]. Several sources of evidence have shown that decreased SHBG is associated with MetS and IR in women with PCOS [28][29][30][31][32].…”