SAT363 The Prevalence And Phenotype Of Polycystic Ovary Syndrome (PCOS) In A Community-Based Population In Sub-Sahara Africa: The Nigeria-PEP Study

Abstract

Abstract Disclosure: C.C. Makwe: None. J.A. Olamijulo: None. M.R. Balogun: None. A.O. Akinkugbe: None. A. Samuel: None. K. Udenze: None. F. Bril: None. R.P. Buyalos: None. J.S. Laven: None. R. Azziz: Advisory Board Member; Self; Arora Forge. Consulting Fee; Self; Rani Therapeutics, Spruce Biosciences, Fortress Biotech, Core Access Surgical Technologies. Grant Recipient; Self; Ferring Pharmaceuticals. Stock Owner; Self; Martin Imaging. Background: Epidemiologic studies of unselected (medically unbiased) populations in many nations indicates that PCOS is clinically evident in 5%-15% of all reproductive-aged women. However, no systematic studies of PCOS have been performed in Sub-Sahara Africa, limiting the ability to develop rational screening and public health approaches to address the disorder in this part of the world. To address this deficit, we established the ‘PCOS Epidemiology and Phenotype in Nigeria (Nigeria-PEP)’ study. Objective: To determine the prevalence and phenotype of PCOS in an unselected population in Nigeria. Materials and methods: Women 18-45 yrs. were selected using multi-stage sampling from the Mushin and Surulere Local Government Areas of Lagos, Nigeria. All underwent a 75 gm, 2-hr. oral glucose tolerance test (OGTT) and a pelvic ultrasound between day 2-7 of the cycle (natural or induced with oral Dydrogesterone 10 mg/day x 5 day), or randomly for women who had a negative progesterone challenge test. PCOS was defined by the Rotterdam 2003 criteria. Clinical hyperandrogenism (CH) was defined by a modified Ferriman-Gallwey score of ≥6; menstrual dysfunction (MD) as menstrual cycle lengths >35 or <25 days; and polycystic ovarian morphology (PCOM) as an antral follicle count (AFC) of ≥20 and/or ovarian volume ≥ 10 cm3 at least in a single ovary. Results: Of the 422 participants recruited for the study, 418 participants had complete data for analysis. Mean (SD) age was 32.3 (8.6) yrs., body mass index (BMI) was 26.6 (9.2) kg/m2, waist circumference was 77.3 (11.5) cm and waist-to-hip-ratio was 0.77 (0.09). Twenty-seven (6.4%) participants were underweight (BMI < 18.5), 209 (50.0%) had normal BMI, 86 (20.6%) were overweight, and 96 (23.0%) were obese (BMI≥ 30 kg/m2). The mean (SD) fasting, 1-hour, and 2-hour plasma glucose were 4.9 (1.0), 6.5 (2.2), and 5.9 (2. 5) mmol/L, respectively; 14 (3.3%) had diabetes, 15 (3.6%) had impaired fasting glucose, 17 (4.1%) had impaired glucose tolerance, and 372 (89%) were euglycemic. Forty-three (10.3%) subjects had CH, 55 (13.2%) had MD, and 139 (33.3%) had PCOM. Our preliminary results, pending hormonal analysis, indicate that at least 8.6% (36/418) of unselected women of reproductive age demonstrated PCOS. Of these, 3 (8.3% of all PCOS and 0.7% of total population) of the subjects had CH, MD, and PCOM, consistent with PCOS Phenotype A; 9 (25% and 2.2%) had CH and MD only, consistent with PCOS Phenotype B; 12 (33.3% and 2.9%) had CH and PCOM only, consistent with PCOS Phenotype C; and 12 (33.3% and 2.9%) had MD and PCOM only, consistent with PCOS Phenotype D. Conclusion: These data suggest that, at a minimum, the prevalence of PCOS in an unselected Nigerian population of reproductive-aged women is 8.6%. Phenotypes C and D appear to be the predominant phenotypes. Further analysis is ongoing. Funding: Ferring Pharmaceuticals; Foundation for Research and Education Excellence Presentation Date: Saturday, June 17, 2023