Differences In Pcos Presentation Among Black Women In California And Alabama.

To compare the PCOS phenotype among Black women in California vs. Alabama. Tertiary-care based cohort study. Black women and adolescents (age >12) from Los Angeles and Birmingham presented for consultation from 1980 to 2010. Demographic data were obtained including age, hyperandrogenism and menstrual cycle history. A modified Ferriman-Gallwey (mFG) was performed to assess clinical hyperandrogenism (defined as mFG>4). Markers of metabolic dysfunction were measured including body mass index (BMI), waist-to-hip ratio (WHR), glucose and insulin during a 2-hour glucose tolerance test. Categorical variables between the groups were compared using student’s t-tests, rank sum or X2 tests, as appropriate. A logistic regression was performed to adjust comparisons for BMI. Three hundred twenty-three Black patients were identified, of which 184 were diagnosed with PCOS by Rotterdam criteria. Alabama patients were younger in age and had higher BMI (Table 1). Even after adjusting for BMI, women in Alabama were more likely to be hirsute, adjusted odd ratio (aOR) 3.08 (CI95%: 1.8-5.2, p<0.001), and were more likely to have oligo-ovulation (aOR 1.97, CI95%: 1.2-3.2, p=0.007). 0 min. and 60 min. glucose, and 60 min. insulin values, were higher in the Alabama cohort.Tabled 1Table 1CaliforniaAlabamaUnadjusted p-valueTotal Black, n=323134189PCOS (%)73 (62.9%)111 (95.7%)<0.001Age (SD), yr32.2 (8.0)28.8 (9.1)0.0007BMI (SD), kg/m231.4 (8.7)34.1 (8.4)0.006WHR (SD)0.85 (0.1)0.84 (0.1)0.35Mean mFG score (SD)5.6 (5.0)8.1 (5.3)<0.001Clinical HA (%)78 (58.2%)155 (82.0%)<0.001Oligo-ovulatory (%)75 (56.8%)138 (74.2%)0.001% elevated glucose, 0 min.2 (5.4%)14 (19.2%)0.04% elevated glucose, 60 min.0 (0%)7 (9.6%)0.048% elevated glucose, 120 min.5 (13.2%)12 (16.4%)0.44% elevated insulin, 0 min.10 (29.4%)33 (42.3%)0.20% elevated insulin, 60 min.24 (68.6%)37 (47.4%)0.037% elevated insulin, 120 min.19 (52.8%)38 (48.7%)0.69 Open table in a new tab In this study, Black women with PCOS in Alabama had a higher prevalence of oligo-ovulation and clinical HA compared with Black women with PCOS in California, even after adjusting for BMI. Some markers of metabolic dysfunction were also higher in Black women with PCOS in Alabama, even after adjusting for BMI. These data suggest that there are geographic differences in PCOS phenotypes, reinforcing the need for more investigation on the environmental determinants of PCOS.