Racial and Ethnic Differences in Metabolic Disease in Adolescents With Obesity and Polycystic Ovary Syndrome

CONTEXT: Polycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity. OBJECTIVE: This work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth. METHODS: A secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (> 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity. RESULTS: Participants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone–binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (P = .002 overall, HW vs NHB [P = .009] vs NHW [P = 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (P = .010 overall, NHW vs NHB P = .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A(1c) (HbA(1c)) was lowest in NHW (overall P < .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P < .001 vs 5.7 ± 0.4%, P < .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P < .001) and prediabetes HbA(1c) 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P < .001) were different between the groups. CONCLUSION: Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.