Regional Variation in Hormonal and Metabolic Parameters of White and Black Women With PCOS in the United States

Context Ongoing research is needed to determine geo-epidemiologic differences of polycystic ovary syndrome (PCOS). Objective Determine hormonal and metabolic parameters of women with PCOS in 2 environments. Methods Prospective cohort study. Setting Tertiary-care based specialty clinics in Alabama and California. Patients or Other Participants A total of 1610 women with PCOS by National Institutes of Health Criteria from 1987 to 2010. Interventions Interview, physical examination, laboratory studies. Main Outcomes Measures Demographic data, menstrual cycle history, and hormonal and metabolic parameters were collected. Hirsutism was defined as modified Ferriman-Gallwey scores >= 4. Androgen values greater than laboratory reference ranges or >95th percentile of all values were considered elevated (hyperandrogenemia). Metabolic parameters included body mass index (BMI), waist-hip-ratio (WHR), glucose tolerance test, and homeostatic model assessment for insulin resistance (HOMA-IR) scores. Results Alabama women with PCOS were younger with a higher BMI. After adjustment for age and BMI, Alabama women with PCOS were more likely hirsute (adjusted odds ratio [aOR], 1.8; 95% CI, 1.4-2.4; P < 0.001), with elevated HOMA-IR scores (adjusted beta coefficient 3.6; 95% CI, 1.61-5.5; P < 0.001). California women with PCOS were more likely to have hyperandrogenemia (free testosterone aOR, 0.14; 95% CI, 0.11-0.18; P < 0.001; total testosterone aOR, 0.41; 95% CI, 0.33-0.51). Results were similar when stratified by White race. In Black women with PCOS, BMI and WHR did not differ between locations, yet differences in androgen profiles and metabolic dysfunction remained. Conclusion Alabama women with PCOS, regardless of Black or White race, were more likely hirsute with metabolic dysfunction, whereas California women with PCOS were more likely to demonstrate hyperandrogenemia, highlighting potential environmental impacts on PCOS.

Automated summary

This study compares women with PCOS in Alabama and California and finds geographical differences in hormonal and metabolic parameters. Women with PCOS in Alabama are more likely to have hirsutism and metabolic dysfunction, while women with PCOS in California are more likely to have hyperandrogenemia.