Insulin Resistance and Endocrine Characteristics of the Different Phenotypes of Polycystic Ovary Syndrome: a Prospective Study
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Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by oligo- or anovulation (ANOV), biochemical or clinical manifestations of hyperandrogenemia (HA) and PCOs. Four phenotypes of PCOS exist [phenotype 1 (ANOV + HA + PCO), phenotype 2 (ANOV + HA), phenotype 3 (HA + PCO) and phenotype 4 (ANOV + PCO)] but the differences between them are not well studied. We compared markers of insulin resistance (IR) and endocrine characteristics between the different PCOS phenotypes.
Methods: We prospectively studied 1212 consecutive women with PCOS and 254 BMI-matched healthy women.
Results: Phenotypes 1-4 were present in 48.2, 30.7, 9.7 and 11.4% of patients, respectively. BMI did not differ between the four phenotypes and controls. Both normal weight and overweight/obese women with phenotypes 1 and 2 were more insulin resistant than controls. Overweight/obese, but not normal weight, women with phenotype 4 were more insulin resistant than controls, while IR in women with phenotype 3 did not differ from controls regardless of obesity. In normal weight subjects, women with phenotypes 1 and 2 were more insulin resistant than women with phenotype 4. In overweight/obese subjects, women with phenotype 1 were more insulin resistant than women with phenotypes 2 and 3 and women with phenotype 4 were more insulin resistant than those with phenotype 3. Circulating androgens were higher in normal weight and overweight/obese PCOS patients with phenotypes 1-3 compared with those with phenotype 4, and higher in normal weight PCOS patients with phenotype 1 than in those with phenotype 2.
Conclusions: Phenotype 1 is associated with more IR and more pronounced HA than phenotype 2. Phenotypes 2 and 4 with obesity, are also characterized by IR. In contrast, phenotype 3 is not associated with IR.
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Helvaci N, Yildiz B Nat Rev Endocrinol. 2024; .
PMID: 39609634 DOI: 10.1038/s41574-024-01057-w.
Zhou M, Yu J, Li X, Ruan Z, Yu S J Cell Mol Med. 2024; 28(8):e18258.
PMID: 38546608 PMC: 10977384. DOI: 10.1111/jcmm.18258.
Liu S, Zhao X, Meng Q, Li B PLoS One. 2023; 18(10):e0293447.
PMID: 37883387 PMC: 10602247. DOI: 10.1371/journal.pone.0293447.
Sparic R, Andjic M, Rakic A, Bjekic-Macut J, Livadas S, Kontic-Vucinic O Hormones (Athens). 2023; 23(1):49-58.
PMID: 37792213 DOI: 10.1007/s42000-023-00494-y.
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Tural Balsak B, Faki S, Burcak Polat S, Orhan K, Koparal S, Keskin M Reprod Sci. 2023; 31(1):239-247.
PMID: 37715066 DOI: 10.1007/s43032-023-01347-0.