A comparison of ovarian morphology and reproductive and metabolic features between South Asian and White women with polycystic ovary syndrome (PCOS)

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine condition, with known variability in the severity of its cardinal features and long-term health consequences across races and ethnicities. Diagnosis of PCOS involves the ultrasonographic identification of polycystic ovarian orphology (PCOM). However, current diagnostic thresholds for PCOM do not account for any impact of race or reflect the potential for race-specific differences in the presentation of PCOS. I aimed to evaluate differences in ovarian morphology between South Asian and White women with PCOS and assess relationships between reproductive / metabolic features and PCOM in both cohorts. Methods: White (n = 30) and South Asian (n = 31) women with PCOS underwent clinical evaluation, venipuncture, and transvaginal ultrasonography. Markers of PCOM (i.e., follicle number per ovary [FNPO] and ovarian volume [OV]) and reproductive / metabolic status were compared between groups. Results: South Asian women with PCOS had lower OV (9.0 vs. 12.5 mL, P 0.01) and slightly lower FNPO (31 vs. 44 follicles, P = 0.06) than White women with PCOS. South Asian women also had more metabolic disturbances than White women, as indicated by higher waist circumference, waist-to-hip ratio, and 2-hour glucose levels (All: P 0.05). Correlations between ovarian morphology and reproductive / metabolic features were variable across cohorts and challenging to interpret due to limited sample sizes. Conclusions: My findings support the need for race-specific diagnostic criteria for PCOM. Future studies would benefit from the inclusion of larger cohorts of South Asian and White women to clarify the importance of race in the manifestation and treatment of PCOS.