Racial influence on the polycystic ovary syndrome phenotype: a black and white case-control study

Abstract

Objective To estimate racial disparities in PCOS phenotype between White and Black women with PCOS. Design Case/control study Setting Two academic medical centers Patients 242 women off of confounding medications in otherwise good health Interventions Phenotyping during the follicular phase or anovulation after overnight fast in women. Main outcome measures Biometric, serum hormones, glycemic and metabolic parameters, and body composition by DEXA. Results We studied 77 White and 43 Black women with PCOS and 35 White and 87 Black controls. Black women with PCOS were very similar reproductively to White women with PCOS. Black women with PCOS had lower serum transaminases, higher HDL-C levels[mean difference (MD): 18.2; 95% CI: (14.3, 22.1) mg/dL], lower triglycerides(MD: -43.2 mg/dL; 95% CI: (-64.5, -21.9)), and enhanced insulinogenic index on the oral glucose tolerance test compared to White women with PCOS. Blacks with PCOS had higher bone mineral density(MD: 0.1 g/cm2; 95% CI: (0.1, 0.2)) and lower percent body fat on DXA (MD: -2.8%; 95% CI:(-5.1, - 0.5)), and overall a higher quality of life. While most of these findings disappeared when the differences with racially matched controls were compared, Black women with PCOS compared to Black controls had lower estradiol levels than White PCOS women compared to White controls(MD: -12.9 pg/mL; 95% CI: (-24.9, -0.8)), higher systolic blood pressure(MD: 9.1 mm Hg; 95% CI: (0.8, 17.4)), and lower fasting glucose levels(MD: -12.0 mg/dL; 95% CI: (-22.3, - 1.7)). Conclusion Racial disparities in PCOS phenotype are minor and mixed. Future studies should explore if race impacts on treatment effects.

Should All Women with Polycystic Ovary Syndrome Be Screened for Metabolic Parameters?: A Hospital-Based Observational Study

“…In addition to sample size, most of the studies that have been performed around the world have argued that there are also racial differences in the distribution patterns of PCOS phenotypes [14–17]. However, this was not supported by a case-control study that was performed by Ladson et al [18], which revealed that differences between black and white PCOS women were minimal.…”

Clinical characteristics of polycystic ovary syndrome: investigating differences in White and South Asian women

“…The wide range of 4–18% in the reported prevalence of PCOS is likely to reflect the different criteria used in the diagnosis of the condition. The prevalence of PCOS across different ethnic groups is largely similar, but ethnicity does seem to affect the clinical and metabolic presentation of these women . Higher rates of type 2 diabetes (T2DM) and cardiovascular events in women with PCOS have been reported previously, and South Asian (SA) ethnicity was associated with diabetes and not with cardiovascular events .…”

Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS

“…Due 64 to the eventual weight gain and cancer risks of thiazolidinediones, 65 prescription of these drugs has been limited only to diabetic 66 patients [4]. In women with PCOS, treatment with metformin 67 ameliorated the cardio-metabolic profile by improving insulin 68 sensitivity, lowering blood glucose and androgen levels, possibly 69 acting through body weight changes [5][6][7][8]. Metformin is more 70 active than oral contraceptives in reducing fasting insulin not 71…”