Endocrine Abstracts

Background: PCOS-associated increased metabolic risk may be selective, owing to its heterogeneous nature. Identification of high-risk individuals could enable better studies and prevention of complications.

Aim: To characterize the metabolic risk, as metabolic syndrome (MetS), of specific PCOS subphenotypes.

Subjects and methods: Romanian PCOS (Rotterdam criteria) and 64 controls, 18–35 years. PCOS subphenotypes were defined: i) oligo-amenorrhoea (OA), hyperandrogenism (H), and polycystic ovarian morphology (P), OA–H–P (n=143, 59.58%); ii) OA–H (n=35, 14.83%); iii) H–P (n=17, 7.08%) and iv) OA–P (n=45, 18.75%). MetS was defined by harmonized IDF (2009) criteria. Total testosterone (TT), free-androgen index (FAI), insulin-sensitivity index (QUICKI) and SHBG are expressed as mean±SEM and compared by ANCOVA, adjusting for BMI and age. MetS prevalences were compared by χ²-test.

Results: MetS prevalence was higher in OA–H–P and OA–H (28.24 and 35.48%) than in controls (10.42%) (P<0.01). MetS frequencies (13.33 and 17.07%) of H–P and OA–P were not significantly different than controls or OA–H–P and OA–H.

The OA–H–P and OA–H had higher TT (0.84±0.02 and 0.89±0.07 vs 0.67±0.07 ng/ml, P<0.05) and FAI (9.59±0.98 and 7.78±1.04 vs 2.88±0.42, P<0.01) and were more insulin-resistant (QUICKI=0.321±0.003 and 0.313±0.007 vs 0.352±0.005, P<0.05) than controls.

Insulin-sensitivity did not differ significantly between the H–P and OA–P and controls (0.318±0.013 and 0.321±0.006 vs 0.352±0.005). SHBG was lower in OA–H–P and OA–H (58.15±5.34 and 61.49±10.42 vs 132.71±19.39 nmol/l, P<0.01) than in controls.

Conclusions: The oligo-anovulatory hyperandrogenic PCOS have the highest MetS prevalences, suggesting they represent more severe PCOS. The ovulatory and normoandrogenic PCOS subphenotypes were not different than controls in MetS prevalence and insulin-sensitivity, suggesting less metabolic risk. However, direct comparison did not identify significant differences of the same parameters between these two and the more severe PCOS subphenotypes.