The following is a summary of “Regional Variation in Hormonal and Metabolic Parameters of White and Black Women With PCOS in the United State,” published in the March 2023 issue of Endocrinology & Metabolism by VanHise, et al.

The variation of polycystic ovary syndrome (PCOS) between geographic locations was poorly understood. Therefore, for a study, researchers sought to assess women’s hormonal and metabolic differences with PCOS in two different regions.

The prospective cohort study was conducted in specialty clinics in Alabama and California. The study included 1,610 women diagnosed with PCOS according to the National Institutes of Health criteria between 1987 and 2010. The participants underwent interviews, physical examinations, and laboratory tests to collect demographic data, menstrual cycle history, and hormonal and metabolic parameters. Hirsutism was defined as modified Ferriman-Gallwey scores ≥4, while hyperandrogenemia was defined as androgen values greater than laboratory reference ranges or >95th percentile of all values. Metabolic parameters included body mass index (BMI), waist-hip-ratio (WHR), glucose tolerance test, and homeostatic model assessment for insulin resistance (HOMA-IR) scores.

After adjustment for age and BMI, women with PCOS from Alabama were more likely to be hirsute (adjusted odds ratio [aOR], 1.8; 95% CI, 1.4-2.4; P < 0.001) and have elevated HOMA-IR scores (adjusted beta coefficient 3.6; 95% CI, 1.61-5.5; P < 0.001). On the other hand, women with PCOS from California were more likely to have hyperandrogenemia (free testosterone aOR, 0.14; 95% CI, 0.11-0.18; P < 0.001; total testosterone aOR, 0.41; 95% CI, 0.33-0.51). These results were consistent across both Black and White race groups. Among Black women with PCOS, there was no difference in BMI and WHR between the two regions, but differences in androgen profiles and metabolic dysfunction persisted.

The study suggested that environmental factors may contribute to the variation of PCOS between geographic locations. Women with PCOS in Alabama had a higher likelihood of hirsutism and metabolic dysfunction, while women with PCOS in California had a higher likelihood of hyperandrogenemia. The findings may have implications for diagnosing and managing PCOS in different regions.

Reference: https://academic.oup.com/jcem/article/108/3/706/6750997