Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite #2310, Chicago, IL, 60611-2914, USA.
Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Reprod Biol Endocrinol. 2021 Mar 3;19(1):36. doi: 10.1186/s12958-021-00719-y.
Polycystic ovary syndrome (PCOS) is a complex and multi-faceted endocrine disorder that affects 5-20% of women. Literature is limited regarding potentially differing PCOS phenotypes among women around the world.
To use Flo app technology to understand the multifaceted characteristics of PCOS across several countries and identify contributing risk factors to the development of this condition.
Flo is a widely used female health and wellbeing app with period tracking functionality that provides a globally representative and medically unbiased perspective on PCOS symptomatology. A chatbot dialog on PCOS was subsequently administered on the Flo application (app) to users from 142 countries (with at least 100 respondents) who have the app running in English during September-October 2019.
For analyses, we selected the five countries with the greatest number of respondents: US (n = 243,238), UK (n = 68,325), India (n = 40,092), Philippines (n = 35,131), and Australia (n = 29,926). Bloating was the most frequently reported symptom among PCOS-positive women and appeared to be the main predictor of PCOS in our model (odds ratio 3·76 [95% CI 3·60-3·94]; p < 0·0001). Additional top predictors of PCOS are high blood cholesterol and glucose levels. As BMI increased, the percentage of women who reported a physician-confirmed PCOS diagnosis also increased. However, women in India did not follow this trend.
Our findings are based on the largest known PCOS dataset and indicate that symptoms are more complex than previously understood. The most frequently reported symptoms (bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness) are broader than those included in the Rotterdam criteria. Future work should reevaluate and refine the criteria utilized in PCOS diagnosis.
多囊卵巢综合征（PCOS）是一种复杂的多方面内分泌紊乱，影响 5-20%的女性。关于世界各地女性潜在的不同 PCOS 表型，文献有限。
使用 Flo 应用程序技术了解多个国家的 PCOS 的多方面特征，并确定导致这种疾病发展的因素。
Flo 是一款广泛使用的女性健康和福祉应用程序，具有月经跟踪功能，对 PCOS 症状提供了具有全球代表性和医学无偏见的观点。随后，在 2019 年 9 月至 10 月期间，Flo 应用程序（app）向来自 142 个国家（至少有 100 名受访者）的用户进行了关于 PCOS 的聊天机器人对话，这些国家/地区的应用程序都使用英语运行。
为了进行分析，我们选择了受访者最多的五个国家：美国（n=243238）、英国（n=68325）、印度（n=40092）、菲律宾（n=35131）和澳大利亚（n=29926）。腹胀是 PCOS 阳性女性最常报告的症状，似乎是我们模型中 PCOS 的主要预测因素（优势比 3.76[95%CI 3.60-3.94]；p<0.0001）。PCOS 的其他主要预测因素是高胆固醇和血糖水平。随着 BMI 的增加，报告经医生确诊的 PCOS 诊断的女性比例也增加。然而，印度女性并没有遵循这一趋势。
我们的发现基于最大的已知 PCOS 数据集，表明症状比以前理解的更为复杂。报告频率最高的症状（腹胀、面部多毛症、不规则周期、色素沉着过度和脱发）比 Rotterdam 标准中包含的症状更广泛。未来的工作应该重新评估和改进 PCOS 诊断中使用的标准。
