Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Abstract

To cite this version:Dorte Glintborg, Hanne Mumm, David Hougaard, Pernille Ravn, Marianne Andersen. Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark. Clinical Endocrinology, Wiley, 2010, 73 (6) Design: Retrospective trans-sectional study.Patients: 1002 premenopausal women with the diagnoses hirsutism or PCOS were divided according to ethnicity: Caucasian (CA, n=784), Middle East (ME, n=190), Asian (n=14), other (n=14).Measurements: Clinical evaluation (hirsutism, BMI, waist, blood pressure), hormone analyses (testosterone, sex hormone binding globulin, prolactin, lipids, insulin, glucose), and transvaginal ultrasound. Oral glucose tolerance tests (OGTT) (n = 499) and ACTH tests (n = 434) were performed in a subgroup of patients.Results (CA vs. ME women): CA women were older [32(25-37) vs. 25(18-32) years, median (quartiles)]and had increased BMI compared to ME women. After correcting for age and BMI CA women were less hirsute, but had increased testosterone levels compared to ME women. The Rotterdam criteria were fulfilled in 56% of both populations but PCO was diagnosed in 47% CA vs. 29% ME women, p<0.01. CA women had increased blood pressure and smoked at a higher frequency (40 vs. 23%), whereas area under the curve for insulin during OGTT was decreased, all p<0.001. Prolactin levels were significantly lower in CA women compared to ME women [7(5-10) vs. 9(6-12) µg/l] and were inversely associated with smoking status. Conclusion:CA women had a more adverse cardiovascular profile than ME women, whereas insulin sensitivity was higher. The prevalence of the individual Rotterdam criteria differed significantly in the two study populations.

A meta-analysis on the association between PPAR-γ Pro12Ala polymorphism and polycystic ovary syndrome

“…PCOS is a heterogeneous disease, but we did not classify our patients due to the clinical phenotypes. Secondly, since most of the original studies derived from European population and the metabolic parameters seemed to be different in PCOS patients with different ethnic descents [44][45][46][47], our findings may not be extended to other descent. Thirdly, due to the limited numbers of original researches enrolled, our results are not conclusive.…”

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

“…The relative risk for obesity was higher in Caucasian women compared with Asian women, whereas central obesity was comparable in the two groups (4). North European women with PCOS were significantly older and more obese, had higher blood pressure, a more adverse lipid profile and smoked at a higher frequency by the time of referral compared with women originating from the Middle East, for whom insulin sensitivity was higher (36). Immigrants in Western countries may be at increased risk for lifestyle diseases such as obesity and diabetes (60).…”

“…Guidelines recommended prospective yearly measurements of blood pressure in women with PCOS (32), but limited data supported that these recommendations should be applied in all women with PCOS. In a Danish study population of women with PCOS, the prevalence of systolic blood pressure >130 mmHg was 46.3% and diastolic blood pressure >85 mmHg was 37.6% (36). A Dutch study reported increased risk of hypertension especially in young patients with PCOS, but patients with PCOS were more obese than controls (40).…”

“…Increased risk for diseases may be attributable to genetic predisposition or to environmental influences such as different exercise or eating habits. In addition, some ethnic subgroups may be relatively protected against the long-term side effects of PCOS (36). It is generally recommended that patients with PCOS are screened for cardiovascular risk factors by the time of diagnosis (2), whereas the intervals for subsequent follow-up are debated.…”

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

“…PCOS women in Europe showed differences in lipid values. Namely, while triglycerides were almost universally elevated in PCOS women, in some Caucasian populations HDL was significantly lower and LDL higher in comparison with other populations or reference controls (179,180). Detailed assessment of the prevalence of different patterns of dyslipidaemia is still needed.…”