Cardiovascular and metabolic characteristics of infertile Chinese women with PCOS diagnosed according to the Rotterdam consensus criteria

• Published in: Reproductive biomedicine online Vol. 21; no. 4; pp. 572 - 580
• Main Authors: Guo, M, Chen, Z.J, Macklon, N.S, Shi, Y.H, Westerveld, H.E, Eijkemans, M.J, Fauser, B.C.J.M, Goverde, A.J
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2010
• Subjects: Adult; Anovulation - complications; Asian Continental Ancestry Group; Cardiovascular Diseases - epidemiology; China - epidemiology; ethnicity; Female; Glucose - metabolism; Hirsutism - complications; Humans; Hyperandrogenism - complications; infertility; insulin resistance; Lipid Metabolism; metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - metabolism; Obstetrics and Gynecology; Phenotype; polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - metabolism; metabolic syndrome; ethnicity; infertility; insulin resistance; polycystic ovary syndrome
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/j.rbmo.2010.04.032

Abstract Polycystic ovary syndrome (PCOS) is strongly associated with metabolic abnormalities in Western women. However, data from other populations and geographical regions are scarce. This study evaluated cardiovascular and metabolic risk factors in Chinese infertile women diagnosed with PCOS using the 2003 Rotterdam consensus criteria. A total of 615 women representing the four PCOS phenotypes (oligo- or anovulation (AO) + hyperandrogenism (HA) + polycystic ovaries (PCO), AO + HA, AO + PCO and HA + PCO) underwent standardized metabolic screening including a 75 g oral glucose tolerance test. All groups presented with similar reproductive characteristics, with the only difference being a significantly higher Ferriman–Gallwey score for hirsutism ( P = 0.01) in the subgroup characterized by HA + PCO. Overall, the prevalence of metabolic syndrome was 6.4%, with no difference among the four groups (range of 2.3–12.2%). Metabolic syndrome was associated with body mass index ( P < 0.001), waist/hip ratio ( P = 0.002), index of insulin resistance ( P = 0.005) and fasting insulin ( P = 0.009) in multivariate analysis. Compared with Caucasians and Chinese women in Westernized societies, mainland Chinese women with PCOS have a low risk of metabolic syndrome and its presence does not vary across the specific PCOS phenotypes. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. PCOS is diagnosed if at least two of three of the following characteristics are present: lack of ovulation (oligo- or anovulation), specific ultrasound characteristics of the ovaries (enlarged ovary and/or increased number of antral follicles), and increased production of androgen hormones and/or its clinical manifestations such as hirsutism and acne. Therefore, four presentations of PCOS can be distinguished. PCOS is also associated with the metabolic syndrome, a clustering of from three to five risk factors of cardiovascular disease. Unfortunately, knowledge about PCOS and its metabolic associations for the Asian region is scarce. The objective of this study was to evaluate cardiovascular and metabolic risk factors in a group of 615 Chinese infertile women with PCOS representing the four PCOS subgroups, from mainland China. Overall, women in the four PCOS subgroups had similar physical, hormonal and biochemical characteristics, with only more hirsutism in the subgroup characterized by overproduction of androgen hormones and ovarian ultrasound characteristics. Of the total group, 6.4% had metabolic syndrome with no differences among subgroups (range 2.3–12.2%). We found that the presence of metabolic syndrome was associated with higher body mass index, higher waist/hip ratio, and a higher index of insulin resistance (HOMA-IR) and higher fasting insulin concentrations. We conclude that in contrast to Caucasians and Chinese women in Westernized societies, mainland Chinese women with PCOS have a low risk of metabolic syndrome and that its presence does not vary among the four PCOS phenotypes.