To Study Polycystic Ovary Syndrome in Taiwanese Women
Condition: Polycystic Ovary Syndrome; Metabolic Syndrome; Cardiovascular Disease
MeSH terms: Polycystic Ovary Syndrome; Cardiovascular Diseases; Metabolic Syndrome; Syndrome
Study type: Observational

Summary: 
      Polycystic ovary syndrome (PCOS) is an extremely common disorder in women of reproductive
      age. Diagnosis of PCOS is principally based on clinical and physical findings. Diagnostic
      criteria and PCOS definitions used by clinicians and researchers are almost as heterogeneous
      as the syndrome. Of those diagnosed with PCOS using the 2003 Rotterdam criteria, 61%
      fulfilled 1990 NIH criteria for unexplained hyperandrogenic chronic anovulation. The patient
      populations with the new phenotypes had less severe ovulatory dysfunction and less androgen
      excess than patients diagnosed using the 1990 NIH criteria. These findings might be common
      across all female populations with PCOS, whether in Oriental or Occidental countries. Data
      for clinical hyperandrogenism indicated that the prevalence of hirsutism in Taiwanese PCOS
      women is lower than that for Caucasians/Western women.

      The extent of metabolic abnormalities in women with PCOS may vary with phenotype, age and
      ethnicity. Obesity represents a major risk factor for metabolic syndrome and insulin
      resistance. Approximately 40-50% of all women with PCOS are overweight or obese. Obese
      subjects with PCOS had a higher risk of developing oligomenorrhea, amenorrhea and biochemical
      hyperandrogenemia than non-obese women with PCOS. Moreover, obese women with PCOS had
      significantly more severe insulin resistance, lower serum LH levels, and lower LH-to-FSH
      ratios than non-obese women with PCOS. PCOS women in Taiwan presented with higher LH-to-FSH
      ratio and lower insulin resistance than PCOS women in Western Countries. However, the average
      body mass index (BMI) was significantly lower in Taiwanese PCOS women than Western women,
      which might partially explain the difference between these two populations in terms of
      clinical and biochemical presentations.

      To further document the ethnic variation between women with PCOS in Taiwan and Western, the
      effect of obesity on the diagnosis and clinical presentations of PCOS-related syndromes
      should not be neglected in future studies. Therefore, the investigators plan to do this
      prospective study for evaluation the clinical and biochemical presentation of Taiwanese women
      with PCOS.
    

Detailed description: 
      1. Method

        1. This study was approved by the Institutional Review Board of the Wan Fang Medical Center
           at Taipei Medical University (WF99041, approved August 2010) and performed at the
           Reproductive Endocrinology Clinic at the Wan Fang Medical Center from 31 August 2010 to
           31 August 2011. The following women were excluded: (i) women who had been diagnosed with
           hyperprolactinemia, hypogonadotropic hypogonadism, premature ovarian failure, congenital
           adrenal hyperplasia, androgen-secreting tumor,Cushing's syndrome, disorders of the
           uterus and chromosomal anomalies; (ii) women who were less than three years past
           menarche or who were older than 45 years; (iii) women who received hormones or
           medication for major medical diseases (diabetes or cardiovascular disease); and (iv)
           women who had had ovarian cysts or ovarian tumors identified by ultrasonographic
           examination.

        2. Statistical analysis: We used chi-squared and Fisher's exact tests to perform
           categorical comparisons and ANOVA to compare the continuous variables. The means of more
           than two groups were compared using one-way ANOVA and post hoc Dunnett's t-test with
           equal variances not assumed.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Polycystic Ovary Syndrome(PCOS)
      
Biospecimen description: 
      Blood sample
    
Keywords: PCOS; DM; Hypertension; CVD