189 - Association of Racial/Ethnic Ancestry with the Prevalence of Cardiometabolic Risk Factors in Female Adolescents with Polycystic Ovary Syndrome (PCOS)

Poster Number: 189
Publication Number: 189.213

Olga Myszko, The Children's Hospital at Montefiore, Bronx, NY, United States; Ellen J. Silver, none, Newberg, OR, United States; Kimberly Graybeal, Albert Einstein College of Medicine, Bronx, NY, United States; Menjin Kuk, Albert Einstein College of Medicine, Bordentown, NJ, United States; Molly O. Regelmann, Children's Hospital at Montefiore, Albert Einstein College of Medicine, BRONX, NY, United States; Susan M. Coupey, Albert Einstein College of Medicine, Chappaqua, NY, United States

Background: PCOS affects an estimated 6% to 12% of reproductive age women globally. Insulin resistance is a component of PCOS that can disrupt normal metabolic function. Metabolic Syndrome (MetS) defines a cluster of risk factors for cardiovascular disease, stroke, and type 2 diabetes mellitus (T2D). Diagnosis of MetS includes 3 or more defined criteria for abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. Information is lacking on the prevalence of MetS in the female adolescent population with PCOS worldwide.

Objective: To provide an updated and expanded description of the metabolic profiles of a multiracial, multiethnic population of U.S. female adolescents newly diagnosed with PCOS.

Design/Methods: A retrospective cohort study at an academic children’s hospital located in one of the most diverse urban counties in the U.S. We searched the electronic health record for new patients with a diagnosis of PCOS from 2016-2021. For this preliminary report, we reviewed a randomly selected group of patient charts and extracted race/ethnicity/ancestry, anthropometrics, physical exam and laboratory results within 6 months of PCOS diagnosis. We diagnosed PCOS using Pediatric Endocrine Society guidelines and used modified Cook criteria to diagnose MetS.

Results: Mean age of the 41 subjects at PCOS diagnosis was 15.4±1.4 years and gynecologic age was 3.9±1.9 years. Mean BMI was 30.9±7.4 kg/m2 and 61% were obese. All had biochemical hyperandrogenism; none met criteria for clinical hyperandrogenism; 61% had acanthosis nigricans, a marker of insulin resistance; 2/41(4.9%) had T2D. At PCOS diagnosis, 12/41(29%) had at least 2 MetS criteria present. ANOVA comparing number of MetS criteria per subject among the 5 racial ancestry groups showed significant difference, p=.04 (Table). Post hoc pairwise analysis showed the South Asian/Mideast ancestry group met more MetS criteria per subject on average than the Black/African group, p=.005, and Caribbean/Central & South American group, p=.01. Overall, 12.2% met criteria for MetS diagnosis with the highest prevalence (42.7%) in those with South Asian/Mideast ancestry.

Conclusion(s): In our multiracial, multiethnic adolescents, PCOS presents primarily with a metabolic phenotype rather than a hyperandrogenic phenotype. These adolescents are at risk for cardiometabolic disease at the time of PCOS diagnosis. Our results emphasize the importance of regular, frequent, monitoring for metabolic disease in adolescents with PCOS like those in our cohort, particularly among those at high risk based on racial ancestry.