Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype - 27/09/17
, Susan Jin, MPH b, Fangbai Sun, MPH b, Richard S. Legro, MD c, Alex J. Polotsky, MD, MSc d, Karl R. Hansen, MD, PhD e, Christos Coutifaris, MD, PhD f, Michael P. Diamond, MD g, Esther Eisenberg, MD, MPH h, Heping Zhang, PhD b, Nanette Santoro, MD dthe
Reproductive Medicine Network
Abstract |
Background |
Women with polycystic ovarian syndrome have a high prevalence of metabolic syndrome and type 2 diabetes mellitus. Blacks and Hispanics have a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since metabolic syndrome is a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in metabolic syndrome among 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-Hispanic blacks, 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/m2) 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-Hispanic black, and Hispanic women. Hispanic women 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 globulin compared to non-Hispanic whites. Non-Hispanic black women had a significantly lower prevalence of metabolic syndrome (24.5% vs 42.2%) compared with Hispanic women, and lower serum triglyceride levels compared to both Hispanics and non-Hispanic whites (85.7 ± 37.3 vs 130.2 ± 57.0 vs 120.1 ± 60.5 mg/dL, P < .01), with a markedly lower prevalence of hypertriglyceridemia (5.1% vs 28.3% vs 30.5%, P < .01) compared to the other 2 groups.
Conclusion |
Hispanic women with polycystic ovarian syndrome have the most severe phenotype, both in terms of hyperandrogenism and metabolic criteria. Non-Hispanic black women have an overall milder polycystic ovarian syndrome phenotype than Hispanics and in some respects, than non-Hispanic white women.
Le texte complet de cet article est disponible en PDF.Key words : ethnicity, metabolism, phenotype, polycystic ovary syndrome, race, sex steroids
Plan
| Supported by National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development Grants U10 HD39005, U10 HD38992, U10 HD27049, U10 HD38998, U10 HD055942, HD055944, U10 HD055936, U10 HD055925, and U10 U54-HD29834 to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core, and Clinical Research/Reproductive Scientist Training (CREST) Grant R258 HD075737. |
|
| K.R.H. received grant support from Ferring International Pharmascience Center, US. L.E., S.J., F.S., R.S.L., A.J.P., C.C., M.P.D., E.E., H.Z., and N.S. have nothing to declare. |
|
| The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) or the National Institute of Health (NIH). |
|
| Cite this article as: Engmann L, Jin S, Sun F, et al. Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype. Am J Obstet Gynecol 2017;216:493.e1-13. |
Vol 216 - N° 5
P. 493.e1-493.e13 - mai 2017 Retour au numéro
Article précédent
- Randomized controlled trial of postoperative belladonna and opium rectal suppositories in vaginal surgery
- Kristina Butler, John Yi, Megan Wasson, Jennifer Klauschie, Debra Ryan, Joseph Hentz, Jeffrey Cornella, Paul Magtibay, Roseanne Kho
- Is vaginal mesh a stimulus of autoimmune disease?
- Bilal Chughtai, Art Sedrakyan, Jialin Mao, Karyn S. Eilber, Jennifer T. Anger, J. Quentin Clemens
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?