Ethnicity Background of Women with Polycystic Ovary Syndrome: Comparison of Clinical, Endocrine, and Metabolic Characteristics

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Abstract
To compare anthropometric, endocrine, and metabolic parameters among White, Black, and Mixed-race women who have polycystic ovary syndrome (PCOS). This cross-sectional study enrolled 392 Brazilian women of different races, 308 women with PCOS and 84 without PCOS. The proportions of differences in races/ethnicities between groups were compared using a chi-squared test with Bonferroni adjustment for the number of comparisons. Comparisons between PCOS and control in each race group were performed using Student t test or Z test where appropriate. Differences among more than two Gaussian variables were determined using one-way analysis of variance followed by a Tukey post hoc test. Age and body mass index as possible confounders of the found results were controlled using a multinominal logistic regression. The proportions of ages and races were not different between women with PCOS and the control group (p = 0.099 and p = 0.978, respectively). Diastolic blood pressure was higher among Black women with PCOS (p < 0.001) and not different among Mixed-race (p = 0.667) or White (p = 0.133) races in the control group. Body weight, body mass index, waist circumference, waist-to-hip ratio, and fat mass were higher in Black women than in White women with PCOS (p < 0.05 for all comparisons). Free testosterone levels were higher among Black women than White women (p < 0.001) and Mixed-race women (p < 0.001) with PCOS, but the levels were not different in the control group. HbA1C was also higher among Black women with PCOS (p = 0.041). Black women with PCOS presented higher concentrations of carbohydrate and lipid than White women. Regarding hormones, free testosterone levels and free androgen index were higher among Black women than among White and Mixed-race women with PCOS. The control group did not present anthropometric, metabolic, and endocrine differences among races. The findings of the current study strongly suggest that ethnic background has a wide implication in the development of comorbidities, diagnosis, or for the clinical assistance of women with PCOS. The analysis of race/ethnicity is recommended in future studies with focus on pathophysiological, biochemical, and clinical characteristics.

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