Prevalence and predictors of metabolic abnormalities in Chinese women with PCOS: a cross- sectional study

BMC Endocrine Disorders

Jie Qiao¹  Shuxin Fu⁹  Xiuxia Wang²  Xueru Song⁶  Zhaolian Wei⁴  Xiaoke Wu⁷  Shulan Lu³  Shangwei Li⁸  Dongzi Yang⁵  Geng Yu¹  Rong Li¹ 

[1] Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, No. 49 North Huayuan Road, Haidian District, Beijing 100191, China;Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China;Department of Obstetrics and Gynecology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, China;Department of Obstetrics and Gynecology, First Affiliated Hospital of Anhui Medical University, Anhui, China;Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong, China;Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Heping, China;Department of Obstetrics and Gyneocology, First Affiliated Hospital of Heilongjiang Chinese Medicine University, Harbin, China;Department of Obstetrics and Gynecology, Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, China;Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central-South University, Changsha, China

关键词: Community;    PCOS;    Metabolic abnormalities;    Predictor;    Prevalence;   

Others  :  1084983
DOI  :  10.1186/1472-6823-14-76

 received in 2013-12-09, accepted in 2014-09-05,  发布年份 2014

【 摘 要 】

Background

Polycystic ovary syndrome (PCOS) is a common condition estimated to affect 5.61% of Chinese women of reproductive age, but little is known about the prevalence and predictors in Chinese PCOS patients. This study aimed to determine the prevalence and predictors of the metabolic abnormalities in Chinese women with and without PCOS.

Methods

A large-scale national epidemiological investigation was conducted in reproductive age women (19 to 45 years) across China. 833 reproductive aged PCOS women, who participated in the healthcare screening, were recruited from ten provinces in China. Clinical history, ultrasonographic exam (ovarian follicle), hormonal and metabolic parameters were the main outcome measures.

Results

The prevalence of metabolic syndrome (MetS) as compared in PCOS and non-PCOS women from community were 18.2% vs 14.7%, and IR (insulin resistance) were 14.2% vs 9.3% (p < 0.001) respectively. After adjusting for age, the indicators (central obesity, hypertension, fasting insulin, SHBG, dyslipinaemia) for metabolic disturbances were significantly higher in PCOS than in non-PCOS groups. Using multivariate logistic regression, central obesity and FAI were risk factors, while SHBG was a protective factor on the occurrence of Mets and IR in PCOS women (OR: 1.132, 1.105 and 0.995).

Conclusions

The risk factors of the metabolic syndrome and insulin resistance were BMI and FAI for PCOS women, respectively. The decrease of SHBG level was also a risk factor for insulin resistance in both PCOS and metabolic disturbance.

【 授权许可】

   
2014 Li et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Li R, Zhang Q, Yang D, Li S, Lu S, Wu X, Wei Z, Song X, Wang X, Fu S, Lin J, Zhu Y, Jiang Y, Feng HL, Qiao J: Prevalence of polycystic ovary syndrome in women in China: a large community-based study. Hum Reprod 2013, 7:1-8.
• [2]March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ: The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010, 25:544-551.
• [3]Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF: Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006, 91:4237-4245.
• [4]Lepor NE, Vogel RE: Summary of the third report of the National Cholesterol Education Program Adult Treatment Panel III. Rev Cardiovasc Med 2001, 2:160-165.
• [5]Vrbikova J, Vondra K, Cibula D, Dvorakova K, Stanicka S, Sramkova D, Sindelka G, Hill M, Bendlova B, Skrha J: Metabolic syndrome in young Czech women with polycystic ovary syndrome. Hum Reprod 2005, 20:3328-3332.
• [6]Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA: Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol 2006, 154:141-145.
• [7]Apridonidze T, Essah PA, Iuorno MJ, Nestler JE: Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005, 90:1929-1935.
• [8]Cheung LP, Ma RC, Lam PM, Lok IH, Haines CJ, So WY, Tong PC, Cockram CS, Chow CC, Goggins WB: Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome. Hum Reprod 2008, 23:1431-1438.
• [9]Moran LJ, Misso ML, Wild RA, Norman RJ: Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2010, 16:347-363.
• [10]Azziz R, Marin C, Hoq L, Badamgarav E, Song P: Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J Clin Endocrinol Metab 2005, 90:4650-4658.
• [11]Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH: Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005, 106:131-137.
• [12]The Rotterdam ESHRE/ASRM‒sponsored PCOS consensus workshop group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004, 19:41-47.
• [13]Alberti KG, Zimmet P, Shaw J: Metabolic syndrome–A new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med 2006, 23:469-480.
• [14]Xing XYYW, Yang ZJ: The diagnostic significance of homeostasis model assessment of insulin resistance in metabolic syndrome among subjects with different glucose tolerance. Chinese J Diabet 2004, 1:182-186.
• [15]Hatch R, Rosenfield RL, Kim MH, Tredway D: Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 1981, 140:815-830.
• [16]The Asia-Pacific perspective: redefining obesity and its treatment http://www.vepachedu.org/TSJ/BMI-Guidelines.pdf webcite
• [17]Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J: Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999, 22:141-146.
• [18]Legro RS, Kunselman AR, Dodson WC, Dunaif A: Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999, 84:165-169.
• [19]Rossi B, Sukalich S, Droz J, Griffin A, Cook S, Blumkin A, Guzick DS, Hoeger KM: Prevalence of metabolic syndrome and related characteristics in obese adolescents with and without polycystic ovary syndrome. J Clin Endocrinol Metab 2008, 93:4780-4786.
• [20]Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO: The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004, 89:2745-2749.
• [21]Wijeyaratne CNBA, Barth JH, Belchetz PE: Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among south Asians and Caucasians: is there a difference? Clin Endocrinol (Oxf) 2002, 57:343-345.
• [22]Ibanez L, Potau N, Zampolli M, Prat N, Virdis R, Vicens-Calvet E, Carrascosa A: Hyperinsulinemia in postpubertal girls with a history of premature pubarche and functional ovarian hyperandrogenism. J Clin Endocrinol Metab 1996, 81:1237-1243.
• [23]LeRoith D, Werner H, Beitner-Johnson D, Roberts CT Jr: Molecular and cellular aspects of the insulin-like growth factor I receptor. Endocr Rev 1995, 16:143-163.
• [24]Meyer C, McGrath BP, Cameron J, Kotsopoulos D, Teede HJ: Vascular dysfunction and metabolic parameters in polycystic ovary syndrome. J Clin Endocrinol Metab 2005, 90:4630-4635.
• [25]Wild RA, Alaupovic P, Parker IJ: Lipid and apolipoprotein abnormalities in hirsute women. I. The association with insulin resistance. Am J Obstet Gynecol 1992, 166:1191-1196. discussion 1196–1197