Endocrine Abstracts

Background: Polycystic Ovary Syndrome (PCOS) is characterized as a triad of menstrual irregularities, hyperandrogenism and polycystic ovarian morphology. There is a wide variation in Body Mass Index (BMI) for those fitting PCOS criteria; Identifying differences in relation to Lean BMI patients’ endocrine markers such as LH/FSH ratio and other markers could help identify key areas for improved phenotypic classification. We aimed to focus on a sequential cohort of PCOS patients amongst a population of diverse ethnicity.

Method: 12 patients who fit the criteria for PCOS seen in the Outpatient Endocrine Clinic at Northwick Park Hospital in London were evaluated and ranked according to BMI, with endocrine data analyzed accordingly. LH and FSH were measured. Given the variation in BMI, the patients were assessed in terms of trends in LH/FSH ratio and LH, FSH alone according to the BMI.

Results: The 12 patients included an extensive range of BMI from 18.7 to 36.2. Within this cohort the 50% of higher BMI had a mean LH/FSH ratio of 2.98 compared to the lower BMI group where it was 2.06 – a 31% difference. However, the 50% of higher BMI had a mean FSH level of 3.68 compared to the lower BMI group where it was 6.28 – a 29% difference in the opposite direction

Discussion: There is large variation in BMI in those with PCOS. Diagnostic error may manifest if classical endocrine features are under-recognised and therefore inappropriate management plans may be enacted. Clarification of variation in hormonal biochemistry between sub-types of PCOS is therefore necessary. We have noted preliminary observational data that LH:FSH ratio may relate to BMI and data in the opposite direction with FSH alone. Further research to classify data based on ethnicity, plus larger cohort studies, will enable improved diagnostic accuracy in such patients.