Effect of ethnicity on the clinical presentations of women with polycystic ovary syndrome: a 20-year retrospective cohort study

Hamidreza Mani; Miles Levy; Melanie Davies; Danielle Morris; Laura Gray; Kamlesh Khunti; Trevor Howlett

doi:10.1530/endoabs.31.P308

Methodology: Polycystic ovary syndrome (PCOS) has a variety of signs and symptoms compromising different phenotypic presentations. Insulin resistance is a known association of PCOS. Despite the documented effect of ethnicity on insulin resistance, there is little known about the effect of ethnicity on the clinical presentations of PCOS. We compared the clinical presentations of white and South Asian (SA) women with PCOS.

Methodology: Retrospective analysis of a clinical database of all PCOS women attending one UK endocrine unit (1988–2009). Androgen criteria are defined as one of; hirsutism, acne, androgenic alopecia or increased free androgen index. Anovulation criteria are defined as oligo-amenorrhoea or infertility. Ethnicity was self-registered by patients. Only white and SA data have been presented.

Results: Of 2207 patients, 684 (30%) were SA. White women had a higher metabolic risk profile (hypertension, smoking and BMI) and less diabetes, while SA had more androgenic and less anovulatory criteria, were younger at presentation and had more deprived background (Table 1).

Conclusion: There appears to be a significant affect of ethnicity on the clinical and phenotypic presentation of PCOS. Understanding these differences may help tailor appropriate management in defined groups of patients with this condition.

Table 1 Characteristics of women with PCOS (reported as mean (S.D.) or % of that population)
Variable*	White (1523)	SA (684)	Total (2207)	P value
Systolic BP	133.2 (15.7)	125.8 (14.7)	130.8 (15.8)	<0.001
Diastolic BP	75.06 (11.3)	71.17 (10.2)	73.79 (11.1)	<0.001
BMI	31.01 (7.9)	28.27 (6.5)	30.16 (0.19)	<0.001
Age	27.3 (7.6)	24.5 (7.3)	26.4 (7.6)	<0.001
Deprivation score	18.86 (14.9)	24.9 (14.4)	20.7 (15.0)	<0.001
Hypertension-Hx	10.4%	7.6%	9.5%	0.023
Smoking-Hx	18.5%	3.7%	13.9%	<0.001
Diabetes-Hx	7.2%	9.5%	7.9%	0.042
Androgen criteria	85.4%	93.0%	87.7%	<0.001
Hirsutism	71.5%	84.6%	75.6%	<0.001
Androgenic-alopecia	3.9%	5.6%	4.4%	<0.01
Acne	21.5%	20.5%	21.2%	0.306
Anovulation criteria	80.5%	74.4%	78.6%	<0.01
Oligomenorrhoea	57.1%	60.8%	58.3%	0.057
Amenorrhoea	18.7%	11.1%	16.4%	<0.001
Infertility	16.5%	13.5%	15.5%	0.039
*BP, blood pressure; Hx, history.

Declaration of funding: Partly funded by ‘Early Career Grant’ from Society for Endocrinology.

It is part of a PhD project supported by Leicester Diabetes Centre.

It is supported by the NIHR ‘Leicester and Loughborough Diet, Lifestyle and Physical activity Biomedical Research Unit’ and Collaboration for Leadership in Applied Health Research and Care (CLAHRC).

Endocrine Abstracts

P308