US regional variations seen in hormonal, metabolic profiles in polycystic ovary syndrome
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Regional differences in hormonal and metabolic profiles in polycystic ovary syndrome exist between women in Alabama, who are more likely to have hirsutism, and those California, who are more likely to have hyperandrogenemia.
Regional profiles were not different when stratified by Black or white race, suggesting effects of environmental factors, according to researchers.
Study results were published in The Journal of Clinical Endocrinology & Metabolism.
“Our study found geographical differences in PCOS in Black and white women, suggesting there are both genetic and environmental influences on how this disease manifests,” Margareta D. Pisarska, MD, associate professor of obstetrics and gynecology at Cedars-Sinai Medical Center, Los Angeles, said in a related press release. “Ongoing research is needed to identify modifiable risk factors for PCOS that may be race- and ethnicity-specific to bring precision medicine to the management of this disease.”
This prospective cohort study included 1,610 women and adolescents aged 14 years and older with PCOS from 1987 to 2010 from tertiary-care specialty clinics in Alabama (n = 889) and California (n = 721). Researchers collected data on demographics, menstrual cycle history, and hormonal and metabolic parameters, including BMI, waist-hip ratio, glucose tolerance tests and homeostatic model assessment for insulin resistance (HOMA-IR) scores.
Hirsutism was defined as a modified Ferriman-Gallwey score of four or higher. Researchers considered participants with androgen values greater than laboratory reference ranges or more than the 95th percentile of all values as elevated.
Women with PCOS who lived in Alabama were younger (28 years vs. 29.5 years; P = .0001) and had higher BMI (33.1 kg/m2 vs. 30.1 kg/m2; P < .001) compared with those living in California. In addition, women with PCOS in Alabama were more likely have hirsutism (adjusted OR = 1.8; 95% CI, 1.4-2.4; P < .001) and elevated HOMA-IR scores (adjusted beta coefficient = 3.6; 95% CI, 1.61-5.5; P < .001) after adjusting for age and BMI.
Women with PCOS living in California had a higher likelihood of having hyperandrogenemia free testosterone (aOR = 0.14; 95% CI, 0.11-0.18; P < .001) and total testosterone (aOR = 0.41; 95% CI, 0.33-0.51; P < .001).
Researchers observed similar results when stratifying by race.
“Since we have now identified that there are geo-epidemiologic differences, we intend to do follow-up studies comparing Black and white women with PCOS, controlling for geo-epidemiologic differences,” Pisarska said in the release. “Furthermore, we are trying to look at factors that are contributing to these differences in order to tailor treatments based on specific needs for improvements in care for all women with PCOS.”
Reference:
- Women may experience different PCOS symptoms depending on where they live. Published Oct. 11, 2022. Accessed Oct. 11, 2022.
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