PCOS racial and ethnic distribution

Polycystic Ovarian Syndrome (PCOS) affects most women in their reproductive age. It is
a common endocrine disorder consisting of anovulation, polycystic ovaries and
hyperndrogenism. According to the Central Disease Control and Prevention (CDC), PCOS is the
most common cause of infertility affecting 6%-12% (about 5 million) of women of reproductive
age. The etiology of the syndrome is unclear whether if it is hereditary. Researchers suggests
certain genes does play a role on a genetic disorder. Goodarzi and Azziz, stated some common
diseases such as diabetes and PCOS, have a complex multifactorial etiology, in which a variety
of predisposing genes, not just one gene, interact with environmental factors to produce disease.
Further studies in some families demonstrated the heritable nature of the syndrome and
phenotypes. (Goodarzi & Azziz, 2006).

Other health implications have been recognized from previous research. Some significant
long-term health consequences include metabolic syndrome, type 2 diabetes, and obesity.
(Engmann & Legro, 2013). Regarding to the disorders etiology and health consequences, the
criteria for diagnosis of PCOS has caused a dilemma through a number of consensus on terms of
agreement. Traditionally, oligomenorrhea and/or hyperandrogenism and/or polycystic ovaries
were based on the 1990 NIH-NICHD to diagnose the syndrome (Diamanti-Kandarakis et al.,
2006). But due to the consensus of excluding the morphology of polycystic ovaries, the revised
2003 Rotterdam diagnostic criteria consider two out of the three to diagnose PCOS. (Diamanti-
Kandarakis et al., 2006).

The various criteria to diagnose PCOS, may affect the prevalence rate of women to develop
PCOS of racial and ethnic distribution. Further research is needed for consideration. Although,
numerous studies have determined women with the syndrome whom are different racial and
ethnic background, leads to severe phenotype of health risk factors. Kauffman et al. studied the
ethnic differences of women with PCOS for insulin resistance. The authors concluded the
prevalence of insulin resistance in the PCOS population overall is 54.5%. Broken down by
ethnicity, insulin resistance demonstrated 73.1% of Mexican American women and 43.8% of
white women. (Kauffman et al., 2002). Engmann et al. focused on the racial and ethnic
differences based on the metabolic phenotype. The authors concluded Hispanic women with
PCOS have the most severe phenotype, both in terms of hyperandrogenism, insulin resistance,
systolic hypertension and hyperglycemia than non-Hispanic whites. Also, non-Hispanic black

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 PCOS racial and ethnic distribution

women with PCOS had a far lower prevalence of metabolic syndrome than Hispanics and less
hypertriglyceridemia than both Hispanics and non-Hispanic whites (Engmann et al., 2017).

In contrast, Chang et al., conducted a study to address the influence of race and ethnicity on
cardiovascular risk factors in women with PCOS. The authors demonstrated a cross-sectional
analysis to better understand the role of race/ethnicity of factor that increases the impact of
cardiovascular risk factors. It was concluded that no observation of an interaction among black,
white and Hispanic women with PCOS that changed cardiovascular risk factor prevelance,
impaired fasting glucose and higher fasting insulin compared to women without PCOS (Chang et
al., 2016). Based on the literature review, further research is needed to expand on racial and
ethnic background to determine the prevalence rate of health consequences linked with the
syndrome. There were few studies including Asian/Pacific Islander women with PCOS to
differentiate risks factors among others and so future researchers should be aware to take that
into consideration.

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 PCOS racial and ethnic distribution

References

Chang, A. Y., Oshiro, J., Ayers, C. & Auchus, R. J. (2016). Influence of race/ethnicity on

cardiovascular risk factors in polycystic ovary syndrome, the Dallas Heart Study. Clinical

Endocrinology, 85: 9299. doi: 10.1111/cen.12986

Consensus on womens health aspects of Polycystic Ovary Syndrome (PCOS). (2012). Human

Reproduction, 27(1), 1424. https://doi.org/10.1093/humrep/der396

Diamanti-Kandarakis, E., Kandarakis, H., & Legro, R. S. (2006). The role of genes and

environment in the etiology of PCOS. Endocrine, 30(1), 1926.

https://doi.org/10.1385/ENDO:30:1:19

Engmann, L., Jin, S., Sun, F., Legro, R. S., Polotsky, A. J., Hansen, K. R., Witter, F. (2017).

Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype.

American Journal of Obstetrics and Gynecology.

https://doi.org/10.1016/j.ajog.2017.01.003

Goodarzi, M. O., & Azziz, R. (2006). Diagnosis, epidemiology, and genetics of the polycystic

ovary syndrome. Best Practice & Research Clinical Endocrinology & Metabolism, 20(2),

193205. https://doi.org/10.1016/j.beem.2006.02.005

Kauffman, R. P., Baker, V. M., DiMarino, P., Gimpel, T., & Castracane, V. D. (2002). Polycystic

Ovarian Syndrome and insulin resistance in white and Mexican American women: A

comparison of two distinct populations. American Journal of Obstetrics and Gynecology,

187(5), 13621369. https://doi.org/10.1067/mob.2002.126650

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PCOS and Diabetes, Heart Disease, Stroke. CDC. (2016). Retrieved from

https://www.cdc.gov/diabetes/library/spotlights/pcos.html