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Cardio Diabetes Medicine 2017 287

South Asians With PCOS -

Metabolic Risk in Future Generation

Dr. Aarathy Kannan, MD, Dip.Diab
Director, Physician and Diabetologist
Sundaram Arulrhaj Hospitals, Tuticorin

Dr. Kiran Palsania & Dr. Bhubaneshwar
DNB resident (internal medicine)

Background pounded by fertility issues later on. The downstream
Polycystic ovary syndrome (PCOS) is the most com- risks of PCOS caused by insulin resistance are an
mon endocrinological problem affecting women with even greater threat to health:
a prevalence estimated at 4-25% depending on the • Risk of diabetes is over seven times someone
diagnostic criteria used Patients with PCOS demon- without PCOS
strate a combination of characteristics which may in-
clude anovulation, oligo or amenorrhoea, hirsuitism, • Increased risk of heart disease with more exten-
acne, evidence of increased serum androgen levels sive atherosclerosis of blood vessels
and morphological changes in the ovary evident • High blood pressure
on ultrasonography. Diagnostically, current practice
uses criteria agreed in Rotterdam 2003 Approximate- • Increased risk of metabolic syndrome
ly 50% of PCOS patients are obese ; a much higher
prevalence than the general population. There is also PCOS IN SOUTH ASIANS:-
a metabolic element to the condition in the form of South Asian refers to those persons who origi-
insulin resistance that may result in long-term mor- nate from the Indian subcontinent (India, Pakistan,
bidity. Sri Lanka, Bangladesh and Nepal) In a communi-
ty-based study in the United Kingdom (UK), it was
PCOS Symptoms and Diagnosis found that polycystic ovaries (PCO) were particularly
common among women of South Asian origin (52%)
Blood testing and diagnostic imaging are confirma- , compared to the prevalence of PCO observed in
tory, but the diagnosis of PCOS is made primarily by a predominately Caucasian population (22%) . The
symptoms, including one or more of the following:
South Asian population, in general, also exhibit a
• Irregular periods higher prevalence of insulin resistance and type 2
diabetes which may increase long term morbidity
• Evidence of excess male hormones (androgens),
which produce symptoms like acne, excess facial among those with PCOS. Recent research indicated
and body hair, and hair loss over the scalp (alo- higher insulin concentrations and lower insulin sensi-
pecia) tivity in South Asian women with PCOS compared to
Caucasian women with PCOS This research also con-
• Obesity cluded that South Asians presenting with anovular
PCOS were significantly younger, had more severe
• Acanthosis-Nigricans, which is a rash consisting
of dark brown to black colored velvety or thick tex- hirsuitism and a higher prevalence of acanthosis ni-
tured skin lesions found in body skin folds (back gricans than their Caucasian counterparts.
or side of neck, armpits, groin, etc.) Health-related quality of life (HRQoL), is a concept
The immediate symptoms of PCOS can be devastat- used to describe the physical, social and emotional
ing to teenagers and young women. Obesity, acne, effects of a disease and its associated treatments .
and facial hair severely impact body image, particu- Research has shown a reduction in the HRQoL of
larly during adolescent years, which is further com- women with PCOS compared with healthy controls

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