Prevalence and Risk Factors of Polycystic Ovarian Syndrome Among an Ethnically Diverse Overweight/Obese Adolescent Population

Background
More remains to be known about polycystic ovary syndrome (PCOS) among overweight/obese adolescents across different ethnicity especially in regards to mental illness as an associated comorbidity.

Hypothesis/Aim
To determine the prevalence of PCOS among overweight and obese adolescents, to further evaluate known risk factors for PCOS in a diverse population, and to discern cardiovascular risk and mental health comorbidity.

Methods
Electronic medical records of patients at an Adolescent Clinic between April 1, 2016 and July 30, 2018 were filtered using the following: obese, overweight and BMI ≥85%. Charts were reviewed to identify the presence of PCOS using NIH criteria, race/ethnicity, and known risk factors for PCOS (lipid, BMI, HA1c, BP) and mental health conditions associated with PCOS (anxiety/depression and self-harm/suicidal ideation).

Results
Of the 451 charts reviewed, 447 were analyzed. Of those, 47% of adolescents were overweight, 53% were obese and 10.5% were diagnosed with PCOS. Ages ranged from 14 to 22 years with a median of 17 years. Patients were predominantly Hispanic (76.1%), and the majority of non-Hispanic patients were from South Asia (Pakistan, Bangladesh, and India). Patients with PCOS were more likely to be hyperlipidemic (19% vs 9.9%, p = 0.04) and obese (67.4% vs 50.9%) than those without PCOS and more likely to have acanthosis (68.9% vs 28.2%). Interestingly, PCOS was not more common among the Hispanic population –57.8% of Hispanic ethnicity with PCOS versus 77.9% of non- Hispanics. Although we were able to identify a significant percentage of our population with depression and anxiety, there was no difference in the prevalence of depression and anxiety with or without PCOS (37% vs 33%, respectively, p = 0.590). Reporting of self-harm and suicidal ideation were comparable in those with and without PCOS (17% vs 17%, p = 0.96). In a logistic regression model, after adjusting for all demographics and clinical features of interest, ethnicity, acanthosis and BMI were all significant risk factors for PCOS.

Conclusion
Patients with PCOS are more likely to be obese, have hyperlipidemia, have a diagnosis of acanthosis and be of Non-Hispanic ethnicity. However, there was no difference in the prevalence of depression/anxiety and self-harm/suicidal ideation among adolescents with or without PCOS.