Polycystic ovary syndrome (PCOS) in Sri Lankans

Abstract

PCOS is the commonest endocrine disease in women. There is a paucity of data on its affliction of Asians, except that migrant Asians have greater severity than white Europeans. Objective: To compare severity of PCOS among Sri Lankans (SL) with British Asians (BA) Methods and design: Cross sectional observational case control study. Recruitment: Consecutive consenting SL PCOS (80) and controls (45); BA with PCOS (47) and controls (11) from specialist endocrine clinics in Colombo and UK respectively. Outcome measures: anthropometry, acanthosis nigricans; family history of diabetes; fasting blood sugar (FBS), fasting plasma insulin(1), insulin resistance (QUICKI), serum testosterone (T), sex hormone binding globulin SHBG), and fasting lipids concentration. Results: All PCOS had significantly greater BMI, waist:hip ratio (WHR), and fasting insulin than matched controls. PCOS Sri Lankans versus British Asians: Mean age 26.3± 0.7 vs. 26.0 ± 0.4 (NS). BMI lower in SL 26.3 vs. 30.59, p = 0.001 but similar WHR (0.97 vs .04). FBS 5.61 ± 0.54 vs. 4.14 ± 0.04 mmol/1, p = 0.004, fasting insulin 242.9 vs. 89.4 pmol/I, p = 0.0003; insulin sensitivity (QUICKI) 0.305 vs. 0.398, p = 0.0003. T 2.88 vs.2.61 nmol/l, p=0.34 and SHBG 29.1 vs. 35.8 nmol/I, (p =0.04). Fasting cholesterol 6.1 vs. 4.45 nmol, p = 0.01; triglycerides 3.3 vs. 2.6 mmol/l, p = 0.03. Type II diabetes in first-degree relatives: 56/80 (70%) vs. 30/47 (63.8%) (NS). Conclusions: Sri Lankans with PCOS are more centrally obese, have significantly greater insulin resistance and lipid derangement than age matched affected British Asians.