Prevalence and Risk Factors of Polycystic Ovary Syndrome Among Adolescent Girls in Urban and Rural Areas of Punjab, Pakistan
PCOS Risk Factors in Lahore Adolescents
DOI:
https://doi.org/10.69750/dmls.02.04.0121Keywords:
Polycystic, Adolescents, Urban, Rural, Obesity, InsulinAbstract
Background: Polycystic ovary syndrome (PCOS) is a leading endocrine disorder during adolescence, conferring reproductive, metabolic, and psychological burdens. Reliable estimates from Pakistan—particularly contrasting urban and rural settings—remain scarce.
Objective: To estimate the prevalence of PCOS and delineate its principal risk correlates among adolescent girls residing in urban and rural districts of Lahore, Pakistan.
Methods: A cross‑sectional survey was undertaken between January and December 2024. Sixty girls aged 13–19 years were recruited by purposive sampling, with equal representation from urban and rural communities. Standardised questionnaires captured sociodemographic and lifestyle variables; physical and anthropometric assessments, transabdominal ultrasonography, and fasting biochemical profiles were obtained. PCOS was defined according to the Rotterdam criteria. Data were analysed with SPSS (version 25.0).
Results: The overall prevalence of PCOS was 26·7%. Urban participants demonstrated a significantly higher prevalence than their rural counterparts (36·7% vs 16·7%; p = 0·04). Urban residency was associated with elevated body‑mass index, greater waist circumference, a higher proportion of obesity, sedentary behaviour, and frequent fast‑food intake. Menstrual irregularity, acne, and hirsutism were the predominant clinical manifestations. Biochemically, girls with PCOS exhibited raised serum testosterone, fasting insulin, fasting glucose, and HOMA‑IR indices (all p < 0·05). A positive familial history of PCOS was more common among urban respondents.
Conclusion: PCOS affects more than one in four adolescent girls in Lahore, with a markedly greater burden in urban communities driven by adiposity, lifestyle patterns, and hereditary predisposition. Early detection, focused health education, and targeted lifestyle modification programmes are essential to mitigate future cardiometabolic and reproductive sequelae.
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References
Sharma P, Mandeep K, and Khetarpal P. CYP19 gene rs2414096 variant and differential genetic risk of polycystic ovary syndrome: a systematic review and meta-analysis. Gynecological Endocrinology. 2021;37(2):126-31.doi: 10.1080/09513590.2020.1813274
Sharma P, Mandeep K, Sachin K, and Khetarpal P. A cross-sectional study on prevalence of menstrual problems, lifestyle, mental health, and PCOS awareness among rural and urban population of Punjab, India. Journal of Psychosomatic Obstetrics & Gynecology. 2022;43(3):349-58.doi: 10.1080/0167482X.2021.1965983
Alina R, Um ES, Hafiz Ghulam Murtaza S. Measuring the Awareness of Polycystic Ovarian Syndrome (PCOS) among Women in Punjab, Pakistan. Scientific Inquiry and Review. 2023;7(1).doi: 10.32350/sir.71.01
Hussain M, Shaikh F, Jamil L, Shaheen A, Afaq MH, Hasni AA, et al. Exploring the Contributing Factors of Polycystic Ovary Syndrome (PCOS). Indus Journal of Bioscience Research. 2025;3(1):696-708.doi: 10.70749/ijbr.v3i1.555
Sharif M, Kiran Majeed H, Tagar K, Lohana S, Rauf A, Sharif M, et al. Reproductive Health-Related Knowledge, Attitude, and Practices in Women of Reproductive Age in Underdeveloped Areas of Punjab, Pakistan. Cureus. 2022;14(11):e31043.doi: 10.7759/cureus.31043
Taghavi S-A, Aramesh S, Azizi-Kutenaee M, Allan H, Safarzadeh T, Taheri M, et al. The influence of infertility on sexual and marital satisfaction in Iranian women with polycystic ovary syndrome: a case-control study. Middle East Fertility Society Journal. 2021;26(1):2.doi: 10.1186/s43043-020-00047-y
Chopra SM, Misra A, Gulati S, Gupta R. Overweight, obesity and related non-communicable diseases in Asian Indian girls and women. European Journal of Clinical Nutrition. 2013;67(7):688-96.doi: 10.1038/ejcn.2013.70
Ganie MA, Chowdhury S, Suri V, Joshi BN, Bhattacharya PK, Agarwal S, et al. Variation in normative values of major clinical biochemistry analytes in healthy reproductive-age women in India: A subset of data from a National Indian Council of Medical Research-Polycystic Ovary Syndrome task force study. Indian Journal of Pharmacology. 2023;55(2).doi: 10.4103/ijp.ijp_694_22
Dhar S, Mridha S, Bhattacharjee P. Mutational Landscape Screening Through Comprehensive In Silico Analysis for Polycystic Ovarian Syndrome–Related Genes. Reproductive Sciences. 2022;29(2):480-96.doi: 10.1007/s43032-021-00752-7
Alshammary AF, Alsobaie SF, Alageel AA, Aldakheel FM, Ansar S, Alrashoudi R, et al. Molecular Role of Asn680Ser and Asp37Glu Missense Variants in Saudi Women with Female Infertility and Polycystic Ovarian Syndrome. Current Issues in Molecular Biology [Internet]. 2023; 45(7):[5494-514 pp.].doi: 10.3390/cimb45070348
Shah SM, Mohanty S, Kaduluri CS, Bhatt GS, Ninama P, Bapat NK. A nationwide cross-sectional study to analyse the impact of the COVID-19 pandemic on lifestyle and manifestations of polycystic ovarian syndrome among clinically diagnosed polycystic ovarian syndrome cases aged 15-49 years. International Journal Of Community Medicine And Public Health. 2022;10(1):240-9.doi: 10.18203/2394-6040.ijcmph20223551
Ganie MA, Chowdhury S, Malhotra N, Sahay R, Bhattacharya PK, Agrawal S, et al. Prevalence, Phenotypes, and Comorbidities of Polycystic Ovary Syndrome Among Indian Women. JAMA Network Open. 2024;7(10):e2440583-e.doi: 10.1001/jamanetworkopen.2024.40583
Shinde KS, Patil SS. Incidence and risk factors of polycystic ovary syndrome among women in reproductive age group attending a tertiary health care hospital in Western Maharashtra. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019;8(7):2804-9.doi: 10.18203/2320-1770.ijrcog20193046
Mahar B, Shah T, Sadiq N, Mangi R, Warsi J, Abbas Q. Vitamin D Deficiency Prevalence in Pakistan: Common, Important, and Neglected: A Comprehensive Meta-Analysis. Journal of Diabetology. 2024;15(4):335-48.doi: 10.4103/jod.jod_61_24
Balaji S, Amadi C, Prasad S, Bala Kasav J, Upadhyay V, Singh AK, et al. Urban rural comparisons of polycystic ovary syndrome burden among adolescent girls in a hospital setting in India. Biomed Res Int. 2015;2015:158951.doi: 10.1155/2015/158951
Rafique A, Salma U, Saleem H. Measuring the Awareness of Polycystic Ovarian Syndrome (PCOS) among Women in Punjab, Pakistan. Scientific Inquiry and Review. 2023;7:1-16.doi: 10.32350/sir.71.01
Jena Samanta L, Parida J, Badamali J, Pradhan A, Singh PK, Mishra BK, et al. The incidence, prevalence, and contributing factors of overweight and obesity among adolescent population of India: A scoping review protocol. PLOS ONE. 2022;17(9):e0275172.doi: 10.1371/journal.pone.0275172
Zulfiqar S, Noor S, Rafique H, Rehman B, Babar A, Shahid T, et al. Investigation of Prevalence and Awareness of Polycystic Ovary Syndrome among Pakistani Females: Polycystic Ovary Syndrome in Pakistani Women. Proceedings of the Pakistan Academy of Sciences: B Life and Environmental Sciences. 2022;59:77-83.doi: 10.53560/PPASB(59-1)703
Hayat FA, Shahzad A, Eman U, Malik L, Aziz H, Akbar SUID, et al. Differential Prevalence of Depression Symptoms in Obese Versus Non-obese Women with Polycystic Ovary Syndrome: Investigating the Impact of Obesity on Depression in PCOS Patients. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(3):27-34.doi: 10.69750/dmls.01.03.033
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