The Association of Polycystic Ovary Syndrome-Like Clinical Features and Socioeconomic Status on Health-Related Quality of Life

多囊卵巢综合征样临床特征与社会经济地位对健康相关生活质量的影响

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Abstract

BACKGROUND: Polycystic Ovary Syndrome (PCOS) affects 8%-13% of reproductive-age women globally, with comorbidities including obesity, insulin resistance, type 2 diabetes, and psychological disorders. Socioeconomic status (SES) significantly impacts health outcomes. METHODS: A community-based, pilot study was conducted in Trinidad among females aged 18-45 years, representing diverse ethnicities and SES. Participants underwent a standardized history and physical exam. Clinical hyperandrogenism (HIR) was assessed using the modified Ferriman-Gallwey scale (HIR ≥6), menstrual dysfunction (MD) as <9 cycles/year, depression via Beck's Inventory, overall health using SF-12 v1, and daytime somnolence with the Epworth Sleepiness Scale. Data analysis included descriptive statistics, analysis of variance, and multinomial logistic regression adjusting for confounders. RESULTS: Among 250 participants (mean age 31.6 ± 7.9 years), we classified 200 with clinical presentations, which included: no MD or HIR (56.7%), MD only (14.4%), HIR only (21.9%), and MD+HIR (7%). Age, income, and education were significantly correlated with clinical presentation. Older age reduced the risk of HIR (mean difference = 4.507, p = 0.004) and MD+HIR (mean difference = 9.063, p < 0.001). Income (OR = 0.37, 95% CI: 0.16-0.87, p = 0.022) reduced MD odds. Self-reported infertility was associated with MD (odds ratio [OR] = 0.27, 95% confidence interval [CI]: 0.11-0.65, p = 0.006). MD+HIR correlated with severe depression (OR = 5.96, 95% CI: 1.62-21.90, p = 0.007). Mental health scores (SF-12 MCS) were lower in women with MD+HIR (mean difference = -11.477, p = 0.005). CONCLUSION: Seven percent of women in this sample showed probable PCOS based on clinical manifestations, with SES impacting quality of life, mental health, and sleep. Higher income reduced MD and MD+HIR risk, while infertility increased MD risk and severe depression was linked to MD+HIR.

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