The impact of ethnicity on the presentation of polycystic ovarian syndrome

Abstract

The effect of ethnicity on the prevalence and presentation of polycystic ovarian syndrome (PCOS) was examined in a cross-sectional study of women with clinical - and ultrasound - diagnosed PCOS. European, Maori and Pacific Island women were seen in proportion to the general population, whereas Indian women were over-represented and Chinese women under-represented. European and Maori women were more likely to present with hirsutism than other ethnic groups (43% versus 25%, p < 0.05), while European women were less likely to present with infertility (46% versus 68%, p < 0.01). The Pacific Island women had little or no acne but other signs of PCOS were similar among ethnic groups. Although less than 10% of patients were referred with obesity, the majority of PCOS women were overweight on examination. Maori and Pacific Island women were more obese and had the highest rates of insulin resistance and lipid abnormalities. The adverse metabolic profile of many of these women, particularly the Maori and Pacific Islanders, is very likely to predispose them to early cardiovascular disease.

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

“…42 Age and ethnicity significantly also influence hair growth due to genetic variances in 5 α-reductase activity. 43 Asian women and adolescents can therefore be expected to demonstrate less terminal hair growth than older women of other ethnic groups (e.g., Mediterranean or East Indian origin). 43 In an effort to reduce some of the subjectivity associated with the clinical evaluation of hirsutism, excessive hair growth in women is generally quantified by the Ferriman-Gallwey scoring system.…”

“…43 Asian women and adolescents can therefore be expected to demonstrate less terminal hair growth than older women of other ethnic groups (e.g., Mediterranean or East Indian origin). 43 In an effort to reduce some of the subjectivity associated with the clinical evaluation of hirsutism, excessive hair growth in women is generally quantified by the Ferriman-Gallwey scoring system. This system grades terminal hair growth on a scale from 0 to 4 (i.e., no terminal hairs to extensive terminal hair growth) on 11 anatomical sites and uses the sum of nine areas to generate an overall hirsutism score.…”

“…Moreover, an overall score does not allow for a description of hair growth patterns, which can be variable among women. 34,35,43 Lastly, and probably most importantly, Ferriman-Gallwey scoring does not adequately overcome the subjectivity associated with assessing hirsutism. In an evaluation of the level of interobserver variability associated with ascribing hirsutism scores, Wild et al showed that agreement in scores was alarmingly poor when three clinicians evaluated the same 21 women, noting a discrepancy of up to 10 points between scores.…”

Polycystic Ovarian Syndrome Trend in a Nutshell

“…It has been observed in Caucasian, Caribbean-Hispanic, African, American, Native American (26), European, Maori, Pacific Island, Indian, Sri Lanka, African Negro, Iranian, Iraqi (27), NonHispanic White (28), Middles East, Asians (29), Chinese (30) and Japanese (31) to name a few.…”

SNP rs2470152 in CYP19 is correlated to aromatase activity in Chinese polycystic ovary syndrome patients

“…The familial aggregation of PCOS, hyperandrogenism and associated metabolic abnormalities indicates a genetic origin for PCOS (5). Heterogeneous clinical manifestations influenced by ethnic factors indicate the involvement of environmental factors (6). To date, dozens of genes have been studied for association with PCOS, mostly using 'case-control study' and 'linkage analysis' methods.…”