Endocrine and Metabolic Profile of Different Phenotypes of Polycystic Ovarian Syndrome.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy associated with wide heterogeneity and serious clinical implications. Prevalence and characteristics of different phenotypes are not well defined. Therefore, this study was planned to determine the prevalence of four phenotypes of PCOS and to evaluate their endocrine and metabolic parameters including insulin resistance and metabolic syndrome with respect to controls.

METHODS: This observational, case-control study was conducted in the gynecology outpatient department of a tertiary care center where 161 PCOS and 50 non-PCOS women were recruited and investigated.

RESULTS: All phenotypes of PCOS had higher BMI with respect to controls (P < 0.000). Overweight women were maximum in phenotype H + O followed by phenotype H + P. Significantly higher levels of luteinizing hormone (P < 0.01), testosterone (P < 0.0001), were observed in all phenotypes of PCOS as compared to controls. Serum cholesterol (P < 0.026) and triglycerides (P < 0.05) were significantly higher in all PCOS phenotypes compared to controls. Levels of fasting (P < 0.000) and post-prandial (P < 0.009) insulin were significantly higher in all phenotypes of PCOS with respect to controls. Mean insulin resistance (IR) was 24.09 % in PCOS and 2 % in controls, prevalence being highest in H + O phenotype followed by H + O + P. Prevalence of metabolic syndrome in women with PCOS was 36.02 %, being highest in H + O + P followed by H + O and that of control was 10 %.

CONCLUSION: All phenotypes of PCOS had deranged endocrine and metabolic profile compared to controls, but prevalence of IR and metabolic syndrome was maximum in hyperandrogenic phenotypes which require a strict surveillance for prospective metabolic disorders as compared to O + P phenotype.