The Prevalence of PCOS in South Asia

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, with ethnic diversity in its manifestation. South Asian patients have a much higher prevalence of PCOS than the controls. A greater PCOS burden among South Asian than White women receiving infertility care has been reported. South Asian patients showed an increased degree of hirsutism, early onset of symptoms, severe insulin resistance, metabolic risks (impaired glucose tolerance (IGT), insulin resistance (IR), diabetes mellitus (DM), hyperlipidemia) and endometrial pathology as compared with Caucasians. South Asians with PCOS also have greater odds of being centrally obese, with one third having the metabolic syndrome that bears no relationship to the androgenic phenotype. South Asians with PCOS manifest early and seek health-care pre-maritally, with irregular menses and hirsutism predominating. They have greater central obesity in proportion to a ‘lower’ BMI, which is linked to their metabolic risk. MetS affects one-third, with age [Formula: see text]35 years, Acantosis Nigricans and BMI [Formula: see text]25 kg/m2 (Asian cut off) having significant association. In a study when Chinese, Filipina and South Asians were compared, the prevalence of PCOS and obesity was significantly higher in South Asians whereas that of diabetes was higher among Filipinas. Genetic components play important roles in the pathogenesis of PCOS, and genome-wide association studies of PCOS have also suggested that similar genetic risk factors exist between Asian and Caucasian patients. Among women with PCOS, Asians have been reported to have lower insulin (vs. Black and Hispanic women) and higher glucose (vs. non-Hispanic White women) levels in response to an oral glucose load. Greater awareness in the clinicians about the differences in PCOS and diabetes among south Asian subgroups is important for targeting screening and prevention efforts. Due to the baseline ethnic predisposition to metabolic syndrome, comprehensive metabolic screening, and counselling regarding future risks of chronic disease should be provided.