Phenotypic spectrum of polycystic ovary syndrome: Clinical and biochemical characterization of the three major clinical subgroups

Wendy Y. Chang, Eric S. Knochenhauer, Alfred A. Bartolucci, Ricardo Azziz

Research output: Contribution to journalArticlepeer-review

164 Scopus citations

Abstract

Objective: We tested the hypothesis that the three clinical phenotypes of polycystic ovary syndrome (PCOS) represent forms of the same metabolic disorder. Design: Prospective cohort analysis. Setting: University-based tertiary care. Patient(s): Three-hundred sixteen untreated consecutive women diagnosed as having PCOS. Intervention(s): None. Main Outcome Measure(s): Each subject underwent an evaluation of ovulatory function, body habitus, acne, and hirsutism; serum free and total testosterone (T), 17-hydroxyprogesterone (17-HP), and DHEAS; and fasting plasma glucose and insulin levels. Insulin resistance and β-cell function were assessed using the homeostatic assessment model equation (HOMA-IR and HOMA-β-cell, respectively). Result(s): The Oligo+HA+Hirsutism phenotype was present in 48% of subjects, Oligo+HA in 29%, and Oligo+Hirsutism in 23%. The three phenotypes did not differ in mean body mass index, waist-to-hip ratio, racial composition, degree of oligo-ovulation, prevalence of acne, or family history of hyperandrogenic symptomatology. However, subjects demonstrating the Oligo+HA+Hirsutism phenotype were the youngest and had the greatest degrees of hyperandrogenemia, hyperinsulinemia, and β-cell function; patients with the Oligo+Hirsutism phenotype where the oldest and had the mildest degrees of hyperandrogenemia, hyperinsulinemia, and β-cell function. Subjects with the Oligo+HA phenotype demonstrated intermediate degrees of hyperandrogenemia and metabolic dysfunction. Conclusion(s): We conclude that the three clinical phenotypes of PCOS do not represent forms of the same metabolic disorder and may be the result of varying degrees of metabolic dysfunction; greater degrees of β-cell function and circulating insulin levels favored the development of hirsutism and frank hyperandrogenemia.

Original languageEnglish (US)
Pages (from-to)1717-1723
Number of pages7
JournalFertility and sterility
Volume83
Issue number6
DOIs
StatePublished - Jun 2005

Keywords

  • Androgens
  • Hirsutism
  • Phenotype
  • Polycystic ovary syndrome

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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