Endocrine Abstracts

Objective: Polycystic ovary syndrome (PCOS) phenotypes, generated by the possible combinations of the three Rotterdam diagnostic criteria, show a different scale of metabolic risk among PCOS women, being greatest in the classic subgroup, followed by the ovulatory and normoandrogenic phenotype. Aldosterone is an important cardiovascular risk factor. Previous studies reported increased levels of aldosterone in PCOS women, suggesting a possible role in the development of some cardiometabolic alterations.

Aim of the study: To evaluate the possible differences of aldosterone levels among the three PCOS phenotypes.

Protocol and Methods: 100 women with PCOS meeting Rotterdam criteria underwent the following hormonal and metabolic evaluations in the early follicular phase: FSH, LH, testosterone, androstenedione, DHEAS, orthostatic aldosterone and renin, total cholesterol, high density lipoprotein cholesterol, triglycerides, glucose and insulin response to oral glucose tolerance test. 17 healthy women, matched for age and BMI, were considered as the control group.

Results: Women belonging to the classic phenotype (40%) show the worst clinical-metabolic picture, being more obese, insulin-resistant, and hirsute and presenting dyslipidemia. Patients with the ovulatory phenotype (37%) show metabolic alterations similar to the classic subgroup, but have lower systolic blood pressure, waist circumference, and triglycerides levels. Patients with normoandrogenic phenotype (23%) have a metabolic profile similar to controls. Aldosterone levels follow this trend, being significantly increased only in classic and ovulatory subgroups.

Conclusions: Classic and ovulatory PCOS phenotypes show more metabolic alterations and higher aldosterone levels compared to normoandrogenic phenotype. Aldosterone could play a certain role in the increased cardiometabolic risk associated to these PCOS phenotypes.