[Clinical, Hormonal and Metabolic Characteristics of Different Phenotypes of Polycystic Ovary Syndrome, in Bulgarian Population]

Aim: Our aim was to investigate the percentage occurrence of different phenotypes of polycystic ovary syndrome (PCOS) in a Bulgarian population, and their clinical, metabolic and hormonal characteristics.

Methods: The study included 110 women with PCOS, diagnosed according to the Europian Society of Human Reproduction & Embriology/American Society for Reproductive Medicine criteria. The women were divided into four phenotypes: hyperandrogenism (HA) + oligo-/ anovulation (OA) + polycystic ovaries at ultrasound (PCO) ( full-blown syndrome, phenotype A); HA + OA (former Institute of Health definition, phenotype B); OA + PCO (phenotype C); and HA + PCO (phenotype D). Serum levels of testosteron, immune-reactive insulin, sex hormone-binding globulin, dehydroepiandrosterone sulfate and lipid metabolism parameters were measured. Free androgen index and homeostasis model assessment of insulin resistance were calculated. Body mass index and waist- to--hip ratio were assessed.

Results: The percentage of phenotypes A, B, C and D in a Bulgarian Population are 53.6%, 12.8%, 11%, 22.6% respectively. The women with the classical form of PCOS (phenotypes A and B) were more obese, had more strongly expressed hyperandrogenemia, and were more insulin--resistant compared with the women of phenotypes C and D.

Conclusion: There is a significant difference in anthropometric, hormonal and metabolic indices between the classical form and the clinical variants of PCOS in the studied Bulgarian population.