Endocrine Abstracts (2002) 3 P212

Phenotype and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians (SA) and Caucasians (C): Is there a difference?

CN Wijeyaratne1, AH Balen2, J Barth3 & PE Belchetz1

1Department of Endocrinology, Leeds General Infirmary, Leeds, UK; 2Department of Obstetrics and Gynaecology, Leeds General Infirmary, Leeds, UK; 3Department of Chemical Pathology, Leeds General Infirmary, Leeds, UK.

Background: PCO is more prevalent among SA than C and IR is central to its pathogenesis; whilst Type 2 diabetes (DM) is commoner in SA. We compared the phenotype and IR in South Asian and Caucasians with PCOS.

Methods: Comparison of consecutive anovular PCOS; 47 SA and 36 Caucasians and their age and weight matched controls (11 SA and 22 Cs).

Results: SA presented earlier (age 26 plus/minus 4 v 30.1 plus/minus 5, p = 0.005). BMI (24.4 plus/minus 0.82/24.2 plus/minus 0.62) and waist: hip ratios (0.76 plus/minus 0.03/0.75 plus/minus 0.01) were similar. Despite similar degree of menstrual irregularity (5v4.8 periods /year) and age of menarche (12.14 plus/minus 0.21v12.14 plus/minus 0.29) more SA had oligomenorrhoea since menarche (41%v28%, p=0.21). Secondary infertility (53%v28%, p=0.03), hirsutism (FG,18v7.5, p=0.0001), acne (65%v33%, p=0.01) and acanthosis nigricans (55%v8%, p<0.001) were all significantly more in SA. None had DM. Although fasting sugar was similar (4.54 plus/minus 0.28v4.17±0.12), fasting insulin was higher (89.4 plus/minus 8.9v48.6 plus/minus 4.8;p=0.0001) and insulin sensitivity (IS) lower (0.398plus/minus 0.007v0.447±0.014; p 0.001) in SA. Each cohort had lower IS than their controls (SA,0.530 plus/minus 0.003,p=0.007vC,0.531 plus/minus 0.018,p=0.001), whilst IS in controls was similar. Finally, serum sex hormone binding globulin was significantly less in SA (35 plus/minus 3.39v55 plus/minus 9.4,p=0.02), whilst serum testosterone was similar (2.69 plus/minus 0.61v2.63 plus/minus 0.59).

Conclusions: South Asians with anovular PCOS have more severe symptoms, higher fasting insulin levels and lower insulin sensitivity than Caucasians. This is the first report confirming greater IR in non-diabetic South Asians with PCOS.

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