Wijeyaratne Chandrika N, Balen Adam H, Barth Julian H, Belchetz Paul E
Department of Endocrinology, The General Infirmary at Leeds, UK.
Clin Endocrinol (Oxf). 2002 Sep;57(3):343-50. doi: 10.1046/j.1365-2265.2002.01603.x.
Polycystic ovary syndrome (PCOS) is more prevalent in South Asian women residing in the UK than in Caucasians. Insulin resistance (IR) is central to the pathogenesis of PCOS, while type 2 diabetes is commoner in South Asians. We aimed to determine a possible ethnic difference in the clinical and biochemical characteristics of South Asian vs. Caucasian women with PCOS.
A case-control cross-sectional observational study of consecutive women with anovular PCOS (47 South Asians, 40 Caucasians) and their age-matched controls (11 South Asians and 22 Caucasians).
Index subjects: a questionnaire-based interview on clinical symptoms and family history; anthropometric measurements, clinical observations of the presence and degree of acne, hirsutism and acanthosis nigricans; transvaginal pelvic ultrasound; biochemical analyses of fasting blood sugar, fasting plasma insulin, fasting lipids, testosterone, and SHBG concentrations.
age- and weight-matched unrelated women from the same ethnic backgrounds without PCOS seeking treatment for male infertility were studied by similar methods to those used with the index subjects.
South Asians with PCOS presented at a younger age (age 26 +/- 4 vs. 30.1 +/- 5 years, P = 0.005). Body mass index (BMI) and waist : hip ratios were similar in the two affected cohorts. More South Asians had oligomenorrhoea commencing at a younger age. Hirsutism (Ferriman Gallwey score 18 vs. 7.5, P = 0.0001), acne, acanthosis nigricans and secondary infertility were significantly more prevalent in South Asians. The fasting glucose was similar (4.52 +/- 0.08 vs. 4.62 +/- 0.09 mmol/l, P = 0.25), the fasting insulin higher (89.4 +/- 8.9 vs. 48.6 +/- 4.8 pmol/l, P = 0.0001) and insulin sensitivity (IS) lower (0.335 +/- 0.005 vs. 0.357 +/- 0.002, P = 0.0001) among South Asians. Serum SHBG was significantly less in South Asians (35 +/- 3.3 vs. 55 +/- 9.4 nmol/l, P = 0.02), while serum testosterone was similar (2.69 +/- 0.11 vs. 2.64 +/- 0.13 nmol/l, P = 0.37).
We conclude that South Asians with anovular PCOS seek treatment at a younger age, have more severe symptoms, and have higher fasting insulin concentrations and lower insulin sensitivity than Caucasians.
多囊卵巢综合征（PCOS）在居住在英国的南亚女性中比在白种女性中更为普遍。胰岛素抵抗（IR）是PCOS发病机制的核心，而2型糖尿病在南亚人中更为常见。我们旨在确定患有PCOS的南亚女性与白种女性在临床和生化特征方面可能存在的种族差异。
一项病例对照横断面观察研究，研究对象为连续的无排卵PCOS女性（47名南亚人，40名白种人）及其年龄匹配的对照（11名南亚人，22名白种人）。
研究对象：基于问卷的临床症状和家族史访谈；人体测量，痤疮、多毛症和黑棘皮病的存在及程度的临床观察；经阴道盆腔超声检查；空腹血糖、空腹血浆胰岛素、空腹血脂、睾酮和性激素结合球蛋白（SHBG）浓度的生化分析。
来自相同种族背景、年龄和体重匹配、无PCOS且因男性不育寻求治疗的无关女性，采用与研究对象相似的方法进行研究。
患有PCOS的南亚女性就诊年龄更小（26±4岁 vs. 30.1±5岁，P = 0.005）。两个患病队列的体重指数（BMI）和腰臀比相似。更多南亚女性在更年轻时开始出现月经过少。多毛症（费里曼 - 盖尔维评分18 vs. 7.5，P = 0.0001）、痤疮、黑棘皮病和继发性不孕在南亚女性中明显更为普遍。空腹血糖相似（4.52±0.08 vs. 4.62±0.09 mmol/L，P = 0.25），空腹胰岛素更高（89.4±8.9 vs. 48.6±4.8 pmol/L，P = 0.0001），胰岛素敏感性（IS）更低（0.335±0.005 vs. 0.357±0.002，P = 0.0001）。南亚女性血清SHBG明显更低（35±3.3 vs. 55±9.4 nmol/L，P = 0.02），而血清睾酮相似（2.69±0.11 vs. 2.64±0.13 nmol/L，P = 0.37）。
我们得出结论，患有无排卵PCOS的南亚女性比白种女性就诊年龄更小，症状更严重，空腹胰岛素浓度更高，胰岛素敏感性更低。
