Prevalence, Phenotypes, and Comorbidities of Polycystic Ovary Syndrome Among Indian Women.

Autor:	Ganie MA; Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.; Department of Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India., Chowdhury S; Department of Endocrinology Metabolism, Institute of Postgraduate Medical Education Research, Kolkata, India., Malhotra N; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India., Sahay R; Department of Endocrinology, Osmania Medical College, Hyderabad, India., Bhattacharya PK; Department of General Medicine, North-Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India., Agrawal S; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, India., Jabbar PK; Department of Endocrinology, Government Medical College, Thiruvananthapuram, India., Suri V; Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Rozati R; Department of Obstetrics and Gynaecology, Maternal Health, Research Trust, Hyderabad, India., Sreenivas V; Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India., Baba MS; Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India., Wani IA; Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India., Rashid H; Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India., Nair A; Department of Endocrinology, Government Medical College, Thiruvananthapuram, India., Shukla A; Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India., Arora T; Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India., Kulkarni B; Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2024 Oct 01; Vol. 7 (10), pp. e2440583. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1001/jamanetworkopen.2024.40583
Abstrakt:	Importance: The prevalence of polycystic ovary syndrome (PCOS) varies across the globe. Indian studies on PCOS are limited by poor design, small sizes, regional representations, and varying methods. Objectives: To estimate the nationwide prevalence of PCOS in India, examine the phenotypic spectrum, and assess the magnitude of comorbidities associated with PCOS. Design, Setting, and Participants: This cross-sectional study recruited 9824 women aged 18 to 40 years from November 1, 2018, to July 31, 2022, across 5 zones of the country. A prevalidated questionnaire dichotomized women into screen-positive and screen-negative groups. Relevant clinical, hormonal, and sonographic assessments categorized women as either women with criteria-based PCOS (ie, National Institutes of Health [NIH] 1990 criteria, Rotterdam 2003 criteria, or Androgen Excess and Polycystic Ovary Syndrome Society [AE-PCOS] criteria), women with partial phenotypes (hyperandrogenism, oligomenorrhea, or polycystic morphology labeled as pre-PCOS), or healthy women, in addition to quantitating various comorbidities. Main Outcomes and Measures: The prevalence and phenotypes of PCOS among women of reproductive age and the burden of comorbidities associated with PCOS. Results: A total of 8993 women (mean [SD] age, 29.5 [6.2] years) were enrolled in this study; 196 women were already diagnosed with PCOS, 2251 were categorized as screen positive, and 6546 were categorized as screen negative. The mean (SD) age of screen-positive women (28.1 [6.4] years) was lower than that of screen-negative women (29.7 [6.1] years) (P < .001), and the mean (SD) age at menarche was higher in the former group (13.2 [1.3] vs 13.1 [1.2] years; P < .001). The national prevalence of PCOS was 7.2% (95% CI, 4.8%-10.8%) by NIH 1990 criteria, 19.6% (95% CI, 12.7%-29.2%) by Rotterdam 2003 criteria, and 13.6% (95% CI, 8.4%-21.6%) by AE-PCOS criteria. Overall, PCOS phenotypes C (501 [40.8%]) and D (301 [24.6%]) were the most common, and 492 women (pre-PCOS subgroup) had oligomenorrhea (n = 75), hyperandrogenism (n = 257), or polycystic ovarian morphology (n = 160) only. Among women with PCOS (n = 1224), obesity was present in 529 (43.2%), dyslipidemia in 1126 (91.9%), nonalcoholic fatty liver disease in 403 (32.9%), metabolic syndrome in 305 (24.9%), impaired glucose tolerance in 111 (9.1%), diabetes in 41 (3.3%), and hypertension in 101 (8.3%). The pre-PCOS subgroup (n = 492) displayed similar metabolic aberrations (dyslipidemia: 390 [79.3%]; metabolic syndrome: 78 [15.9%]; nonalcoholic fatty liver disease: 163 [33.1%]; impaired glucose tolerance: 62 [12.6%]; diabetes: 7 [1.4%]; and hypertension: 26 [5.3%]). Conclusions and Relevance: In this cross-sectional study of reproductive-age women recruited across India, the prevalence of PCOS was high, with phenotype C being predominant. Most of these women had metabolic abnormalities. These findings are crucial for developing preventive and therapeutic strategies, potentially integrating PCOS management into national health programs.
Databáze:	MEDLINE
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