Prevalence of metabolic syndrome risk factors in women with PCOS: findings from a multi-ethnic cohort
Veiga, Alexis de Figueiredo
MetadataShow full item record
BACKGROUND: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. It is characterized by oligomenorrhea/menstrual irregularity, androgen excess, and polycystic ovary morphology. Currently there are three distinct diagnostic criteria used to ascertain PCOS in the population: The National Institutes of Health (NIH) criteria created in 1990 and later reviewed in 2012, the Rotterdam criteria established in 2003, and the most recent criteria by the Androgen Excess & PCOS Society (AE-PCOS) criteria developed in 2006. Some prevalence studies suggest that PCOS affects 6.5-8% of the population while others state 10-20% qualify for a PCOS diagnosis. Recent literature shows patients with PCOS have a 43% prevalence rate or 2-fold higher rate than the age-adjusted sample of all ages in the general US population of developing Metabolic Syndrome (Met-S ) (Apridonidze et al. 2005; Essah, Wickham, and Nestler 2007). This is important because it can alert physicians to refer their PCOS patients to a nutritionist or endocrinologist as a preventive measurement. OBJECTIVES: This thesis based on The Ovulation and Menstruation Health (OM) Pilot Study, sets out to accomplish the following: ascertain the prevalence of PCOS in different racial/ethnic groups, determine Body-Mass Index (BMI) distribution patterns in PCOS participants based on how they were diagnosed (by a physician/self-diagnosed), and most importantly to determine the prevalence of Met-S risk factors in PCOS vs. Non-PCOS groups. METHODS: The (OM) Pilot Study is an online survey with clinical, community, and online recruitment. After a consent and screening process, the survey asks questions related to demographics, anthropometrics, menstrual cycles, contraceptive history, medications and supplement use, PCOS, reproductive health, general health, diet and lifestyle and lastly, pregnancy and birth history. The questions in this online survey, were designed for an 8th-grade reading level to improve comprehension by a diverse cohort of women. This was done to help address the lack of diversity and PCOS ascertainment in pre-existing cohorts. RESULTS: Following recruitment for The OM Pilot Study, 388 participants completed the consent form and 4 declined consent. 384 completed screener and 34 were deemed not eligible because: 18 were no longer menstruating and 16 were unable/unwilling to provide an email address to the receive survey; thus 350 were eligible. Of those 350 participants that were deemed eligible, only 283 started survey. 283 individuals determined to be eligible based on their gender, capacity to menstruate, and age started the survey. Age eligibility was ≥18 years old. 249 completed the survey through its last section (XIII. Pregnancy & Birth History). Of the 283 participants who enrolled and were eligible to partake in the study, 177 (64.1%) identified as White, 22 (7.97%) as Hispanic/Latina/Spanish Origin, 34 (12.3%) as Black/African American, 4 (1.4%) as East Asian, 5 (1.8%) as Southeast Asian, 7 (2.5%) as South Asian, 27 (9.8%) selected more than 1 race/ethnicity, and 7 (2.5%) chose not to answer (Table 5). Participants from the PCOS group had higher prevalence for all the risk factors for Met-S when compared to Non-PCOS group: abdominal fat determined as those who tend to gain weight around stomach/waist (73% versus 60%), abdominal fat ascertained by body figure (33% versus 17%), hypertension (6.9% versus 3.1%), high cholesterol (20.7% versus 8.8%), diabetes (5.3% versus 1.0%), non-alcoholic fatty liver disease (NAFLD) (5.2% versus 0.5%), and lastly sleep apnea (SA) (5.2% versus 2.1%). More noticeably is the absolute difference in prevalence in abdominal fat as determined by the body figure image in which the PCOS group (33%) had a 16% higher prevalence than the Non-PCOS group (17%). Participants that reported having PCOS diagnosed by a physician (37) had a higher prevalence of overweight/obese women (73%) than those that self-diagnosed (23) with PCOS (56.5%). CONCLUSIONS: The OM Pilot Study has demonstrated that it is possible to launch and recruit a diverse sample group representative of the actual population. With this new tool, future studies can better assess risk factors associated with Met-S in PCOS patients taking into consideration their racial/ethnic background.