Cardiovascular and metabolic characteristics of infertile Chinese women with PCOS diagnosed according to the Rotterdam consensus criteria

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. PCOS is diagnosed if at least two of three of the following characteristics are present: lack of ovulation (oligo- or anovulation), specific ultrasound characteristics of the ovaries (enlarged ovary and/or increased number of antral follicles), and increased production of androgen hormones and/or its clinical manifestations such as hirsutism and acne. Therefore, four presentations of PCOS can be distinguished. PCOS is also associated with the metabolic syndrome, a clustering of from three to five risk factors of cardiovascular disease. Unfortunately, knowledge about PCOS and its metabolic associations for the Asian region is scarce. The objective of this study was to evaluate cardiovascular and metabolic risk factors in a group of 615 Chinese infertile women with PCOS representing the four PCOS subgroups, from mainland China. Overall, women in the four PCOS subgroups had similar physical, hormonal and biochemical characteristics, with only more hirsutism in the subgroup characterized by overproduction of androgen hormones and ovarian ultrasound characteristics. Of the total group, 6.4% had metabolic syndrome with no differences among subgroups (range 2.3-12.2%). We found that the presence of metabolic syndrome was associated with higher body mass index, higher waist/hip ratio, and a higher index of insulin resistance (HOMA-IR) and higher fasting insulin concentrations. We conclude that in contrast to Caucasians and Chinese women in Westernized societies, mainland Chinese women with PCOS have a low risk of metabolic syndrome and that its presence does not vary among the four PCOS phenotypes.