Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Hacettepe Ankara, Turkey.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Hacettepe Ankara, Turkey.
Reprod Biomed Online. 2021 Apr;42(4):799-818. doi: 10.1016/j.rbmo.2020.12.006. Epub 2020 Dec 16.
This systematic review aimed to assess variations in the clinical presentation and treatment outcomes of patients with polycystic ovary syndrome (PCOS) belonging to different ethnicities. A search was performed for studies comparing various clinical aspects of PCOS in two or more different ethnic groups. After screening 2264 studies, 35 articles were included in the final analysis. In comparison with White women with PCOS (wPCOS), East Asian women with PCOS (eaPCOS) were less hirsute, whereas Hispanic women with PCOS (hPCOS), South Asian women with PCOS (saPCOS) and Middle Eastern women with PCOS (mePCOS) were more hirsute. saPCOS had higher androgen and lower sex hormone-binding globulin (SHBG) concentrations, mePCOS had higher DHEAS concentrations, and hPCOS and Black women with PCOS (bPCOS) had lower SHBG and DHEAS measures than wPCOS. Menstrual disturbances were more frequent in eaPCOS. Both saPCOS and eaPCOS had lower body mass index with increased central adiposity. hPCOS and bPCOS were more obese. saPCOS, mePCOS, hPCOS and bPCOS had a higher prevalence of insulin resistance than wPCOS. bPCOS had a better lipid profile but higher blood pressure and cardiovascular risk. Indigenous Australian women with PCOS were more obese and more insulin resistant with higher androgen concentrations. The clinical phenotype of PCOS therefore shows a wide variation depending on ethnicity.
本系统评价旨在评估不同种族的多囊卵巢综合征（PCOS）患者的临床表现和治疗结局的差异。我们检索了比较两个或多个不同种族 PCOS 患者不同临床特征的研究。经过筛选 2264 篇研究，最终有 35 篇文章纳入了分析。与白人 PCOS 患者（wPCOS）相比，东亚 PCOS 患者（eaPCOS）的多毛症较少，而西班牙裔 PCOS 患者（hPCOS）、南亚 PCOS 患者（saPCOS）和中东 PCOS 患者（mePCOS）的多毛症较多。saPCOS 患者的雄激素和较低的性激素结合球蛋白（SHBG）浓度较高，mePCOS 患者的 DHEAS 浓度较高，hPCOS 和黑人 PCOS 患者（bPCOS）的 SHBG 和 DHEAS 水平低于 wPCOS。eaPCOS 患者的月经紊乱更为频繁。saPCOS 和 eaPCOS 患者的体重指数较低，中心性肥胖增加。hPCOS 和 bPCOS 患者更肥胖。saPCOS、mePCOS、hPCOS 和 bPCOS 患者的胰岛素抵抗发生率高于 wPCOS。bPCOS 患者的血脂谱较好，但血压和心血管风险较高。患有 PCOS 的澳大利亚原住民女性更肥胖，胰岛素抵抗更严重，雄激素浓度更高。因此，PCOS 的临床表型因种族而异，存在广泛的差异。
