PCOS, diabetes risks among Asian women vary by ethnic subgroup
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Risk profiles for polycystic ovary syndrome and type 2 diabetes differ among younger Chinese, Filipina and South Asian women, according to an analysis of electronic health records, suggesting targeted screening efforts are likely needed.
“Studies that look at racial and ethnic disparities often use one aggregate category for Asian, rather than looking at specific ethnic groups, such as Asian Indian, Chinese, Filipino, Japanese, Korean and Vietnamese,” Joan C. Lo, MD, senior research scientist at the Kaiser Permanente Division of Research in Oakland, California, told Healio. “Our study found that the risk profiles for two metabolic conditions, PCOS and diabetes, differed among younger Chinese, Filipina and South Asian women. While the risk for diabetes was higher in both Filipina and South Asian women compared with Chinese women, the risk for PCOS was higher in South Asian but not Filipino women when compared with Chinese women. The higher burden of PCOS among South Asian women is noteworthy and might have been masked if Asians were examined as a single group.”
In a cross-sectional, retrospective study, Lo and colleagues analyzed data from 19,258 Chinese women, 23,213 Filipina women and 19,108 South Asian women aged 21 to 44 years with at least one clinic visit in 2016 where BMI data were measured (mean age, 34 years). Researchers classified obesity based on the lower intervention threshold of a BMI of at least 27 kg/m² recommended for adults of Asian descent by the American Diabetes Association. PCOS and type 2 diabetes were defined as two ambulatory diagnoses for either condition in 2015-2016 with a history of diabetes pharmacotherapy. Researchers used logistic regression analyses to assess risks for PCOS and diabetes among Filipina and South Asian vs. Chinese women. The findings were published in Diabetes Care.
Within the cohort, prevalence of obesity was 15.3% for Chinese women, 38.3% for Filipina women and 30% for South Asian women. Among Chinese, Filipina and South Asian women, the prevalence of PCOS was 1%, 1.5% and 3.3%, respectively, whereas the prevalence of diabetes was 1.1%, 4.2% and 2.5%, respectively.
The prevalences of PCOS and type 2 diabetes were much higher for women with obesity in these same respective ethnic groups: 3%, 3% and 5.9% for PCOS; and 4.4%, 8.2% and 5.3% for type 2 diabetes.
In logistic regression models adjusted for age, BMI and current smoking status, South Asian women had a 2.6-fold higher adjusted OR for PCOS than Chinese women (95% CI, 2.2-3.1), but the odds for PCOS for Filipinas vs. Chinese women were similar, with an adjusted OR of 0.9 (95% CI, 0.7-1.1).
South Asian women and Filipina women had higher odds for type 2 diabetes compared with Chinese women, with adjusted ORs of 1.7 (95% CI, 1.4-2) and 2.3 (95% CI, 1.9-2.6) respectively.
“Clinicians need to be aware that not all Asians have the same health risks; specific ethnicity matters,” Lo told Healio. “Greater awareness of these differences is necessary to improve individual-level and population-level screening and prevention efforts.”
Lo said the findings highlight the need for researchers to move beyond using only one category for Asians, and to also focus studies on specific Asian ethnic groups.
“Our findings add to previous research that has shown aggregation of Asians into one group masks differences in diabetes risk and emphasizes the need for more studies that examine similarities and differences in health conditions among Asian subgroups,” Lo said.
For more information:
Joan C. Lo, MD, can be reached at joan.c.lo@kp.org.
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