In insulin resistant, young women with PCOS elevated serum AGEs and their receptor RAGE have been reported. The present study (approved by the local ethical committee) was undertaken to determine whether increased levels of serum AGEs in PCOS is a distinct finding compared with age- and BMI-matched women, presenting the isolated components of the syndrome and whether serum AGE levels were different among PCOS phenotypes. A total of 193 lean non-insulin resistant women were studied. 100 women diagnosed as PCOS (Rotterdam criteria), and further divided to quartiles of well-defined phenotypes. 68 women matched for age and BMI with the isolated components of the PCOS phenotype (HYPER=biochemical hyperandrogenemia only, n=25; ANOV=anovulation only, n=21 and PCO=US-PCO morphology only, n=22) were also studied along with 25 women, who served as controls. Serum AGE levels as well as the metabolic, hormonal profiles and intravaginal ultrasound were determined in all subjects. PCOS population phenotypes and controls did not differ in BMI (P=0.152), waist-to-hip ratio (WHR; P=0.495), fasting insulin concentration (P=0.655) and glucose-to-insulin ratio (GIR; P=0.320). Total PCOS women (exhibited statistically higher AGEs levels (7.96±1.87 U/ml, P<0.001) compared with women with isolated hyperandrogenemia (5.61±0.61 U/ml), anovulation (5.53±1.06 U/ml) and US-PCO (5.26±0.25 U/ml) as well as with the controls (5.86±0.89 U/ml). The present study shows, for the first time, that women with PCOS had statistically significant elevated serum AGE levels compared with women with isolated hyperandrogenia, anovulation and US-PCO. No difference was detected in AGEs levels among the different PCOS phenotypes. The above data suggest that serum AGEs is a distinct finding characterizing only women suffering from PCOS.