A survey of the polycystic ovary syndrome in the Greek island of Lesbos: Hormonal and metabolic profile

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, chro nic anovulation, and oligomenorrhea (O/M). PCOS has variable clinical pheno types, biochemical features, and metabolic abnormalities. To determine the prevalence of PCOS in the Greek population as well as the metabolic paramet ers, we performed a cross-sectional study of 192 women of reproductive age (17-45 yr), living on the Greek island of Lesbos. They were divided into 4 groups according to the presence of hirsutism (defined as a Ferriman-Gallwe y score greater than or equal to 6) and O/M: group N (n = 108), regular men ses and absence of hirsutism; group 1 (n = 56), regular menses and hirsutis m; group 2 (n = 10), O/M and absence of hirsutism; and group 3 (n = 18), O/ M and hirsutism. Body mass index, waist to hip ratio, and mean blood pressu re did not differ among the studied groups. Hormonal profile was assessed b y measuring free testosterone (FT). The prevalence of PCOS, defined by the presence of O/M and biochemical hyperandrogenism (FT greater than or equal to 95th percentile of the normal women), was estimated to be 6.77% (13 wome n of 192). Higher FT levels were observed in group 3 (O/M and hirsutism) co mpared with groups N (P < 0.00001) and 1 (P < 0.0001) and in groups I (hirs utism) and 2 (O/M) compared with group N (P < 0.0001 and P < 0.005, respect ively). Sex hormone-binding globulin levels were lower in women with PCOS a nd in groups 1 and 3 than those in group N (P < 0.002, P < 0.02, and P < 0. 002, respectively) independently of the body mass index. The metabolic prof ile was investigated by measurements of fasting glucose (FG), fasting insul in (FI), and estimation of the fasting glucose to insulin ratio (FG:I ratio ). After covariance adjusted for the BMI, Fl levels were higher in group 3 and in women with PCOS than in the normal (P < 0.005 and P < 0.002, respect ively) and the hirsute (P < 0.05 and P < 0.02, respectively) women, whereas FG levels did not differ among the studied groups. The FG:I ratio was lowe r in group 3, group 1, and in women with PCOS than in normal women (P < 0.0 5). Finally, a high incidence of family history of diabetes mellitus (P = 0 .001) and menstrual disorders (P = 0.01) was observed in women with PCOS, i n contrast to the normal and hirsute women. In conclusion, PCOS appears to be a particularly common endocrine disorder in the Greek population under study (prevalence, 6.77%); furthermore, it is associated with certain metabolic abnormalities. These data also suggest t hat the severity of the fasting hyperinsulinemia is associated with the sev erity of the clinical phenotype of hyperandrogenism independently of obesit y.