Changes in the prevalence of polycystic ovary syndrome in China over the past  decade

Rui Yang; Qin Li; Zehong Zhou; Weiping Qian; Jian Zhang; Ze Wu; Lei Jin; Xueqing Wu; Cuilian Zhang; Beihong Zheng; Jichun Tan; Guimin Hao; Shangwei Li; Tian Tian; Yongxiu Hao; Danni Zheng; Yuanyuan Wang; Robert J Norman; Rong Li; Ping Liu; Jie Qiao

doi:10.1016/j.lanwpc.2022.100494

Changes in the prevalence of polycystic ovary syndrome in China over the past decade

Yang R, Li Q, Zhou Z, Qian W, Zhang J, Wu Z, Jin L, Wu X, Zhang C, Zheng B, Tan J, Hao G, Li S, Tian T, Hao Y, Zheng D, Wang Y, Norman RJ, Li R, Liu P, Qiao J

Published August 2022 The Lancet Regional Health. Western Pacific, 25, 100494

DOI 10.1016/j.lanwpc.2022.100494 PMID 35669932 PMC PMC9162959

RRM Academy Synopsis

PCOS became more common in Chinese women from 2010 to 2020

Polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), became more common among married Chinese women. Two national surveys with the same methods, in 2010 and 2020, show the rise. Among women aged 20 to 44, prevalence rose from about 6 out of 100 to about 9 out of 100.

Key Findings

Among women aged 20 to 44, weighted prevalence rose from 5.6% (95%CI: 5.1%, 6.0%) in 2010 to 8.6% (95%CI: 7.6%, 10.0%) in 2020.
In 2020, 826 of 12,815 women aged 20 to 49 met the Rotterdam criteria. Weighted to the population, 7.8% (95%CI: 7.0%, 9.0%) were affected, an estimated 24.0 million women in China.
Prevalence fell with age, from 14.7% (95%CI: 11.6%, 18.6%) at ages 20 to 24 to 1.2% (95%CI: 0.7%, 1.8%) at ages 45 to 49.
Among women with PMOS / PCOS, primary infertility rose from 4.2% to 9.2% and obesity from 13.0% to 18.1% between the 2010 and 2020 surveys (p <0.001).
In 2020, PMOS / PCOS was more likely among overweight women (OR, 1.64; 95% CI, 1.36 to 1.97) and obese women (OR, 2.77; 95% CI, 2.20-3.48) than among normal-weight women.

Interpretation

This is a pair of national cross-sectional surveys of married Han Chinese women, carried out with the same methods in 2010 and 2020. The comparison spans ages 20 to 44 and shows how common the condition was at each point in time. The authors note that only 8 of the 15 provinces surveyed in 2020 were also surveyed in 2010; a sensitivity analysis limited to those 8 provinces gave similar results. The findings support continued national surveillance of PCOS / PMOS prevalence in China.

RRM Context

In 2026 an international consensus in The Lancet renamed PCOS as PMOS. The new name reflects a condition that involves several body systems. The Rotterdam criteria stay the same. Restorative reproductive medicine asks what is causing the condition in each woman, starting with the ovulatory cycle and her metabolic picture. It evaluates both partners when a couple faces infertility.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Polycystic ovary syndrome (PCOS) has become a major international public health concern. However, because of controversy about the diagnostic criteria and patient selection, estimates of its absolute prevalence and change with time vary greatly.

Methods

We conducted two consecutive nationwide epidemiological surveys of the prevalence of PCOS in representative samples of reproductive-aged women in China in 2010 and 2020. Face-to-face interviews were performed by trained interviewers in each survey. All participants completed a questionnaire and underwent a physical examination, blood sampling, and transvaginal pelvic ultrasound. We assessed hyperandrogenism (H), chronic anovulation (O), and polycystic ovaries (P) to classify the presence of PCOS using the Rotterdam criteria. The prevalence of PCOS among reproductive-aged women was estimated after consideration of differential probabilities of selection and population distribution. We conducted a logistic regression analysis by using the probability of PCOS as a function of the survey year to acquire the trend information across the years.

Findings

28,739 respondents completed the survey, including 15,924 in the previously published 2010 survey and 12,815 in the new 2020 survey. In 2020, 826 participants could be diagnosed as having PCOS, with a weighted prevalence of 7.8% (95%CI: 7.0%, 9.0%) among women aged 20-49 years, leading to an estimate of 24.0 million women of reproductive age affected by this condition in China as a whole. The estimated prevalence in 2020 was higher than that of a decade ago despite identical research methods suggesting a two-thirds increase over the study period. Women with PCOS in 2020 also appeared to have a more severe phenotype overall than those of a decade ago, possibly reflecting a significantly higher prevalence of obesity, hyperandrogenism, and infertility.

Interpretation

The prevalence of PCOS in Chinese women has increased significantly over the past 10 years. PCOS is a significant public health problem in women of reproductive age in China and national policy and guidelines should be re-examined in the light of the current data.

Funding

National Key R&D Program of China and the National Natural Science Foundation of China.

Read the guide

PMOS / PCOS: Causes, Diagnosis, and Treatment

Topics

PMOS / PCOS › Diagnosis › Diagnostic Criteria · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

Rui Yang, Qin Li, Zehong Zhou, Weiping Qian, Jian Zhang, Ze Wu, Lei Jin, Xueqing Wu, Cuilian Zhang, Beihong Zheng, Jichun Tan, Guimin Hao, Shangwei Li, Tian Tian, Yongxiu Hao, Danni Zheng, Yuanyuan Wang, Robert J Norman, Rong Li, Ping Liu, Jie Qiao

R Yang, Q Li, Z Zhou, W Qian, J Zhang, Z Wu, L Jin, X Wu, C Zhang, B Zheng, J Tan, G Hao, S Li, T Tian, Y Hao, D Zheng, Y Wang, Bob Norman, Rob Norman, Bobby Norman, R Norman, R Li, P Liu, J Qiao

PMID 35669932 35669932 DOI 10.1016/j.lanwpc.2022.100494 10.1016/j.lanwpc.2022.100494 Yang et al. 2022, Yang 2022

Changes in the prevalence of polycystic ovary syndrome in China over the past decade

PCOS became more common in Chinese women from 2010 to 2020

Key Findings

Interpretation

RRM Context

Abstract

Read the guide

Topics

By this author

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