The prevalence and phenotypic manifestations of polycystic ovary syndrome (PCOS) among infertile Sudanese women: a cross-sectional study

Abstract

Background Polycystic ovary syndrome (PCOS) is a global health problem associated with significant morbidity during reproductive age. Only a few published studies that address the clinical manifestations and phenotypic presentation of the disease have been conducted in Africa, including Sudan. Thus, this study aimed to evaluate the clinical and biochemical presentation of the different PCOS phenotypes among infertile Sudanese women. Methods A cross-sectional, descriptive study was conducted from January to December 2019. A total of 368 infertile women with PCOS (based on the Rotterdam criteria) were recruited from a fertility center in Khartoum, Sudan. Clinical, hormonal, and ultrasonographic characteristics were described and compared between the four phenotypes of PCOS. Results Majority (321 [87.2%]) of the women had oligo/anovulation (OA). Polycystic ovary morphology on ultrasound appeared in 236 (64.1%) women, acne in 171 (46.5%) women, acanthosis nigricans in 81 (22.0%) women, and hirsutism in 101 (27.4%) women. Phenotype D was the most prevalent among infertile Sudanese women (51.6%), followed by phenotype B (22.6%), phenotype C (18.2%), and phenotype A (7.6%). No statistical differences in the body mass index and hormonal profile between the four phenotypes were noted. Women with phenotype A were older and had high mean blood pressure, and a higher waist/hip ratio was observed among women with phenotype D. Conclusion Unlike the global distribution of PCOS phenotypes, Sudanese women uniquely expressed phenotype D as the most prevalent. More epidemiological studies are needed in the region due to geographical, ethnic, and genetic variations.

Phenotypes of polycystic ovary syndrome and accompanying hormonal disturbances

“…There have been ethnical differences according to different places and countries. For example, in contrast to the global prevalence of PCOS phenotypes, Phenotype D was found prevalent among Sudanese women (7). Diversity in frequencies of PCOS phenotypes could be clarified by whether the women were investigated in medical care or during an ordinary health control (8).…”

Acanthosis Nigricans: Pointer of Endocrine Entities

“…Another example is a cross-sectional Sudanese study on 368 infertile females with PCOS, which manifested with AN (22%), acne (46%), hirsutism (27%), as well as oligo/anovulation (87%) [ 120 ]. A retrospective study on dermatologic findings among 92 patients with PCOS (aged between 11 and 24 years, mean age of 15.9 years) identified 85% of them with AN, as well as acne (93%), hirsutism (38%), alopecia (2%), and hidradenitis suppurativa (16%) [ 121 ].…”

Non-alcoholic fatty liver disease across endocrinopathies: Interaction with sex hormones

“…NAFLD-associated endocrinopathies, may be clinically displayed as other pathological conditions such as sex hormone imbalance. PCOS-a multifaceted disorder with a spectrum of clinical presentations- is known as the most prevalent endocrine disease in women of childbearing age ( 8 ). PCOS is a potent risk factor for anovulatory infertility with a prevalence of 5-20% worldwide based on the used diagnostic criteria ( 9 ).…”

“…More precisely, disease prevalence has been reported 6-10% based on the classic definition, while, the number reaches to 18-20% by considering the Rotterdam criteria due to comprising meddler phenotypes in the absence of hyperandrogenism (HA) ( 10 ). Current diagnostic characteristics of PCOS include chronic ovulatory dysfunction, clinical and/or biochemical HA and polycystic ovarian morphology confirmed through ultrasonography ( 8 ). PCOS is diagnosed when at least two of the mentioned criteria are present after excluding other endocrine conditions ( 8 ).…”