Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is the most prevalent endocrinopathy among women during reproductive age. Using ESHRE/ASRM diagnosis of PCOS is considered when 2 of 3 criteria are present: polycystic ovary morphology (PCOM), oligo/anovulation (ANOV) and hyperandrogenism (HA). These criteria form four different phenotypes: A (ANOV, HA, PCOM), B (ANOV, HA), C (HA, PCOM) and D (ANOV, PCOM). Several studies have found differences in anthropometric, hormonal and metabolic characteristics between PCOS phenotypes. Among the non-insulin-derived indices, the single-point insulin sensitivity estimator (SPISE) index showed better accuracy than other indicators in the prediction of metabolic syndrome. The aim of this study was to analyze anthropometric and metabolic characteristics in different PCOS phenotypes and compared to control group. Subjects and methodsWe analyzed 307 women with PCOS divided into four phenotypes groups PCOS-A (n=126, age 25.63±4.6 years, BMI 24.97±6.2 kg/m²), PCOS-B (n=40, age 26.13±6.4 years, BMI 28.33±7.3 kg/m²), PCOS-C (n=83, age 26.06±5.6 years, BMI 24.91±5.4 kg/m²) and PCOS-D (n=58, age 25.26±4.6 years, BMI 21.09±3.1 kg/m²) and 87 women in control group (age 29.25±5.8, BMI 23.33±6.1 kg/m²). Body composition was analyzed using bioimpedance. Lipid indices, basal glucose and insulin were measured, while HOMA-IR and SPISE index were calculated.

Results: Compared to control group only women with PCOS-B had higher BMI, waist circumference (WC), body fat mass, body and trunk fat percentage (P<0.001, P<0.001, P=0.001, P=0.002, P=0.008, respectively), while same characteristics were higher in phenotypes PCOS-A, B and C in comparison to PCOS-D phenotype. Women with PCOS-B had more body fat mass and higher WC compared to PCOS-A group. Both control group and all patient with PCOS showed similar HOMA-IR and basal insulin levels, but SPISE index was statistically lower in PCOS-B group compared to controls and in PCOS A, B and C group compared to PCOS-D group, as well in PCOS-A than in PCOS-B group. SPISE index showed strong negative correlation in all phenotype groups with body and trunk fat mass, body and trunk fat percentage, total body water, BMI and WC and negative correlation with HOMA-IR in PCOS-A, B and C group (r=−0.368, P<0.001, r=−0.433, P=0.013, r=−0.405, P<0.001, respectively).

Conclusion: Not all patient with PCOS have same cardiometabolic risk factors. PCOS-B phenotype showed most prominent metabolic risk factor profile. SPISE index seems to represent accurate risk marker in more metabolic weighted PCOS-A and PCOS-B. The assessment of different risk factors in PCOS phenotypes could be used for prediction of long-term metabolic outcomes.