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Cited by 144Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype

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Engmann, Lawrence, Jin, Susan, Sun, Fangbai, Legro, Richard S., Polotsky, Alex J., Hansen, Karl R., Coutifaris, Christos, Diamond, Michael P. +74 more·2017·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2017.01.003PMC PMC5420474
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Abstract

Background Women with polycystic ovarian syndrome have a high prevalence of metabolic syndrome and type 2 diabetes mellitus. Blacks and Hispanics have a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since metabolic syndrome is a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in metabolic syndrome among women with polycystic ovarian syndrome is important for prevention strategies. However, data regarding racial/ethnic differences in metabolic phenotype among women with polycystic ovary syndrome are inconsistent.Objective We sought to determine if there are racial/ethnic differences in insulin resistance, metabolic syndrome, and hyperandrogenemia in women with polycystic ovarian syndrome.Study design We conducted secondary data analysis of a prospective multicenter, double-blind controlled clinical trial, the Pregnancy in Polycystic Ovary Syndrome II study, conducted in 11 academic health centers. Data on 702 women with polycystic ovarian syndrome aged 18-40 years who met modified Rotterdam criteria for the syndrome and wished to conceive were included in the study. Women were grouped into racial/ethnic categories: non-Hispanic whites, non-Hispanic blacks, and Hispanic. The main outcomes were the prevalence of insulin resistance, metabolic syndrome, and hyperandrogenemia in the different racial/ethnic groups.Results Body mass index (35.1 ± 9.8 vs 35.7 ± 7.9 vs 36.4 ± 7.9 kg/m 2) and waist circumference (106.5 ± 21.6 vs 104.9 ± 16.4 vs 108.7 ± 7.3 cm) did not differ significantly between non-Hispanic white, non-Hispanic black, and Hispanic women. Hispanic women with polycystic ovarian syndrome had a significantly higher prevalence of hirsutism (93.8% vs 86.8%), abnormal free androgen index (75.8% vs 56.5%), abnormal homeostasis model assessment (52.3% vs 38.4%), and hyperglycemia (14.8% vs 6.5%), as well as lower sex hormone binding globulin compared to non-Hispanic whites. Non-Hispanic black women had a significantly lower prevalence of metabolic syndrome (24.5% vs 42.2%) compared with Hispanic women, and lower serum triglyceride levels compared to both Hispanics and non-Hispanic whites (85.7 ± 37.3 vs 130.2 ± 57.0 vs 120.1 ± 60.5 mg/dL, P < .01), with a markedly lower prevalence of hypertriglyceridemia (5.1% vs 28.3% vs 30.5%, P < .01) compared to the other 2 groups.Conclusion Hispanic women with polycystic ovarian syndrome have the most severe phenotype, both in terms of hyperandrogenism and metabolic criteria. Non-Hispanic black women have an overall milder polycystic ovarian syndrome phenotype than Hispanics and in some respects, than non-Hispanic white women.

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  • PCOS is the most common endocrinopathy among women across all races and ethnicities.

    “it is the most common endocrinopathy among women across all races and ethnicities [2]”

    From Availability and Use of Digital Technology Among Women With Polycystic Ovary Syndrome: Scoping Review (2025) · cites this paper as [2]

    The Introduction describes PCOS as a significant public-health concern, and the Abstract and Discussion compare its metabolic phenotype across racial and ethnic groups. None of those passages says PCOS is the most common endocrinopathy among women, across all races and ethnicities. Searches for that phrase and for 'most common endocrine disorder' did not locate the claim in our copy. (LLM, conf=0.75)

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Authors
Engmann, L., Jin, S., Sun, F., Legro, R. S., Polotsky, A. J., Hansen, K. R., Coutifaris, C., Diamond, M. P., Eisenberg, E., Zhang, H., Santoro, N., Bartlebaugh, C., Dodson, W., Estes, S., Gnatuk, C., Ober, J., Brzyski, R., Easton, C., Hernandez, A., Leija, M., Pierce, D., Robinson, R., Awonuga, A., Cedo, L., Cline, A., Collins, K., Krawetz, S., Puscheck, E., Singh, M., Yoscovits, M., Barnhart, K., Lecks, K., Martino, L., Marunich, R., Snyder, P., Alvero, R., Comfort, A., Crow, M., Schlaff, W., Casson, P., Hohmann, A., Mallette, S., Christman, G., Ohl, D., Ringbloom, M., Tang, J., Wright Bates, G., Mason, S., DiMaria, N., Usadi, R., Lucidi, R., Rhea, M., Baker, V., Turner, K., Trussell, J., DelBasso, D., Huang, H., Li, Y., Makuch, R., Patrizio, P., Sakai, L., Scahill, L., Taylor, H., Thomas, T., Tsang, S., Yan, Q., Zhang, M., Haisenleder, D., Lamar, C., DePaolo, L., Guzick, D., Herring, A., Bruce Redmond, J., Thomas, M., Turek, P., Wactawski-Wende, J., Rebar, R., Cato, P., Dukic, V., Lewis, V., Schlegel, P., & Witter, F.
Affiliations
  • University of Connecticut (US)
  • Yale University (US)
  • Pennsylvania State University (US)
  • University of Colorado Anschutz (US)
  • University of Oklahoma (US)
  • Hospital of the University of Pennsylvania (US)
  • Augusta University (US)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
Corresponding author
Engmann, Lawrence
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2017-05
Volume
216
Issue
5
Pages
493.e1-493.e13
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2017.01.003
PMC
PMC5420474
OpenAlex
W2576830570
Cited by
144
References
40
Citations by year
2026: 10 · 2025: 30 · 2024: 21 · 2023: 17 · 2022: 17 · 2021: 18 · 2020: 16 · 2019: 8 · 2018: 3 · 2017: 4
FWCI
9.85
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR001863)
  • National Center for Advancing Translational Sciences
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10HD039005, U10HD038998, U10HD055942, U10HD077680, R01HD029834, U10HD055925, U10HD027049, U10HD055944, U10HD038992, U10HD055936, R25HD075737)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
Keywords
polycystic ovary syndrome, racial and ethnic differences, metabolic syndrome, insulin resistance, hyperandrogenemia, type 2 diabetes, cardiovascular risk, Hispanic women, Black women, hirsutism, sex hormone-binding globulin, free androgen index, hypertriglyceridemia, insulin sensitizers, metformin, rosiglitazone
MeSH terms
Adolescent, Adult, Blood Glucose, Female, Hirsutism, Humans, Insulin Resistance, Phenotype, Polycystic Ovary Syndrome, Sex Hormone-Binding Globulin, Triglycerides, Hypertriglyceridemia, Body Mass Index, Hyperandrogenism, Metabolic Syndrome, Racial Groups, Waist Circumference, Young Adult

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