SUN-107 Persistently Higher Risk of Polycystic Ovary Syndrome Among U.S. Adolescent Females of Asian Ethnicity Independent of Weight Status

Abstract Disclosure: A. Naidu: None. L.C. Greenspan: None. J.A. Darbinian: None. S. Naderi: None. N.D. Ramalingam: None. J.C. Lo: None. BACKGROUND: Polycystic ovary syndrome (PCOS) is a female endocrine disorder and a known risk enhancer of cardiovascular disease. Prevalence has increased among adolescents, likely due to the obesity epidemic. We previously observed a PCOS prevalence of 0.7% among adolescent females (2012-2019) rising to 2.8% among those with obesity; prevalence was notably higher among Filipina (5.7%), Chinese (6.7%) and South Asian (7.8%) females with obesity. This follow-up study examines PCOS prevalence in a more contemporary population of adolescent females in pediatric care (2021-2022). METHODS: This retrospective, cross-sectional study examined data from females aged 13-17y with pediatric well-child visits in a US healthcare system during 2021-2022. Children with underweight body mass index (BMI <5th percentile) were excluded. PCOS was based on diagnosis (ICD-10 E28.2) at clinical encounters within 1 year of the well-child visit. Race/ethnicity was based on self/family-reported data. BMI was classified as healthy (5th to <85th percentile), overweight (85th to <95th percentile), and obesity (≥95th percentile), including moderate (BMI 100-119% of the 95th percentile) and severe obesity (≥120% of 95th percentile). Multivariable logistic regression was used to examine the association of race/ethnicity with PCOS (non-Hispanic White, NHW as reference), adjusting for age and BMI level. Odds ratios (OR) with 95% confidence intervals [CI] are reported. RESULTS: Among 83,025 adolescent females (mean age 15.3 ±1.4y), 25,232 were NHW, 6,344 Black, 23,111 Hispanic, 17,619 Asian/Pacific Islander (API), and 10,719 Other/unknown race. The overall prevalence of PCOS was 1.3%, with 0.8% (NHW), 1.2% (Black), 1.7% (Hispanic), and 1.5% (API), including 0.9% (Chinese), 2.0% (South Asian), 2.1% (Filipina), 2.0% (Native Hawaiian/Pacific Islander, NHPI), and 1.4% Other/Unspecified API. Among those with obesity, PCOS prevalence was higher at 4.4%, with 3.3% (NHW), 3.2% (Black), 5.0% (Hispanic), and 6.2% (API), including 7.7% (Chinese), 8.6% (Filipina), 6.0% (South Asian), 2.7% (NHPI), and 6.0% (Other/Unspecified API). Compared to NHW and adjusting for age and BMI level, South Asian (OR 3.1 [2.1-4.6]), Filipina (2.8 [2.0-3.8]), Chinese (2.1 [1.4-3.3]), and Other/Unspecified API (2.4 [1.9-3.0]) females had much higher risk of PCOS, and Hispanic females to a lesser extent (1.4 [1.2-1.7]). Findings for NHPI were not significant (1.6 [0.9-2.7]). CONCLUSION: Similar to our prior findings, persistently higher risk of PCOS was observed among contemporary Asian adolescents, independent of weight status. South Asian, Filipina, and Chinese females had 3.1-fold, 2.8-fold, and 2.1-fold higher risk of PCOS, respectively, compared to NHW counterparts. These findings emphasize the need to examine causative factors for metabolic and reproductive health outcomes in the rapidly growing Asian American population. Presentation: Sunday, July 13, 2025