US Adolescents of Asian Ethnicity Have Higher Risk of Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is an endocrine disorder that is rising in prevalence among adolescents, attributable in part to the obesity epidemic. PCOS disproportionately affects Asian females, including those without obesity. Given the higher burden of adolescent PCOS and heightened susceptibility in Asian populations, this study examines the prevalence of diagnosed PCOS by race/ethnicity in a contemporary, real-world population of US adolescents.

We conducted a retrospective study of 126,861 female adolescents aged 13-17 years with well-child visits during 2021-2024 in a California healthcare system. The prevalence of diagnosed PCOS was reported overall and by body mass index (BMI) category. The odds of PCOS (odds ratio [OR], 95% confidence interval) by race/ethnicity was examined using logistic regression, adjusting for age, BMI category, and neighborhood deprivation index (NDI).

The prevalence of PCOS was 1.1% overall, ranging from 1.6 to 1.7% (Hispanic, Filipina, South Asian, and Native Hawaiian/Pacific Islander, NHPI), 1.3% (Vietnamese), 1.1% (Black), and 0.7-0.8% (White and Chinese). Prevalence of PCOS was 4.1% among those with obesity, ranging from 2.7 to 3.3% (White, Black, and NHPI), 4.8% (Hispanic), 5.7-6.2% (Chinese, Vietnamese, and South Asian), and 7.5% (Filipina). Adjusting for age, BMI category, and NDI quartile, Vietnamese (OR 3.0 [1.7-5.2]), South Asian (2.8 [2.0-3.9], Filipina (2.6 [2.0-3.4]), Chinese (1.8 [1.2-2.7]), and Hispanic (1.5 [1.3-1.7]) adolescents had higher odds of PCOS compared with White adolescents.

Contemporary US adolescents of South Asian, Filipina, Vietnamese, and Chinese descent have about 2- to 3-fold higher adjusted odds of PCOS than White adolescents, and Hispanic females have 1.5-fold higher odds. These findings emphasize the importance of systematic surveillance in at-risk populations.