Wael Taha

Poly cystic ovarian syndrome (PCOS) is common among reproductive age women. The biologic and clinical features of PCOS are not well characterized in US minorities. Since a large Middle Eastern (ME) population lives in Michigan we retrospectively compared clinical and biological features of PCOS (hyperandrogenism/hyperandrogenemia ± oligomenorrhea) in ME patients (pts) to those of other ethnicities. We used serum levels of total testosterone (TT)>55 ng/dL, free testosterone (FT)>0.53 ng/dL or DHEA-S >380 μg/dL as thresholds for hyperandrogenemia. Pts were excluded if prolactin > 30 ng/mL, TSH< 0.2 or > 4.8 μIU/mL, or age < 16 years. Out of 201 charts reviewed, 107 met our criteria: 60 were ME, 29 Caucasians, 15 African Americans & 3 others. At presentation, the age of ME pts was similar to that of the non ME group (24.9 year ± 1.0 vs. 26.7 ± 1.1, P=0.22). However, their body weight (BW) and body mass index (BMI) were significantly lower than the non-ME group (BW: 190.1 ± 7.0 vs. 228.6± 9.2 lb, P<0.001; BMI: 34.3 ± 1.2 vs. 40.5 ± 1.6, p<0.005). There was no significant differences in serum TT or FT levels (TT: 62.0 ± 2.7 vs. 70.6 ± 4.6, P=0.12 and FT: 1.7 ± 0.2 vs. 1.8 ± 0.3 ng/dL, P=0.78). The concentrations of DHEA-S ( ME:283 ± 25 mcg/dl vs. Non-ME: 241 ± 44 mcg/dl) (P < 0.40), LH, or FSH were not significantly different between the two groups. Interestingly, the fasting insulin concentrations were significantly lower in the ME than in non-ME pts (13.7± 1.9 vs.22.4±2.5, P<0.008) although there was no difference in serum concentrations of total, LDL and HDL cholesterol nor triglycerides. The fasting glucose over insulin ratio was at the limit of significance (ME: 9.9 ± 2.3 and Non-ME: 5.4 ±0.7, p=0.08). Among the PCOS clinical features amenorrhea was significantly less prevalent among ME pts (12 out of 58 vs. 22 out of 47, P <0.006). Acanthosis nigricans and diabetes were more prevalent in non-ME pts than in ME patients (acanthosis nigricans: 11 out of 55 vs. 18 out of 45 patients, P <0.05; diabetes: 0 out of 59 vs. 5 out of 47. P <0.05). There were no differences among the groups in the prevalence hyperlipidemia, or in the family history of diabetes, hypertension, PCOS and thyroid disease. We therefore conclude that although PCOS women of ME descent have comparable levels of serum androgens to age-matched non-ME patients, however, they are less likely to present with amenorrhea and have lower BMI, lower insulin levels and lower prevalence of diabetes. Nothing to Disclose: FAE, OA, PDV, RK, WT, ABA-S