Endocrine Abstracts

JOINT2914

Introduction: Polycystic ovary syndrome (PCOS) is a multifaceted endocrinopathy characterized by a combination of reproductive, metabolic, and dermatological aspects. Among its defining features, clinical hyperandrogenism stands out as a hallmark manifestation, presenting with hirsutism, acne, and alopecia. While hyperandrogenism is observed in both obese and non-obese phenotypes of PCOS, the severity and presentation may vary between these groups. This study compares clinical hyperandrogenism in obese and non-obese PCOS women.

Subjects and Methods: This analytical cross-sectional study was conducted on 122 patients diagnosed with PCOS at the Endocrinology and Diabetology Department of FARHAT HACHED Hospital in Sousse from January to December 2024. Two groups were formed based on body mass index (BMI): the Obese PCOS (O-PCOS) group with a BMI above 25 kg/m² and the Lean PCOS (L-PCOS) group with a BMI below 25 kg/m². The study focused on various aspects of clinical hyperandrogenism. The severity of acne, hirsutism, and alopecia was assessed using the Global Acne Evaluation Scale, the modified Ferriman-Gallwey score, and Ludwig’s classification of female hair loss.

Results: Among participants, 38 were classified as lean (31.14%), while 84 were categorized as obese (68.85%). The average age was 23.61±4.97 years. Clinical hyperandrogenism was present in 89.3% of participants. Acne was the most frequent aspect, with a prevalence of 93.4%, followed by hirsutism (90.1%) and alopecia (35.2%). The mean ages of onset for these aspects were similar between L-PCOS and O-PCOS groups: 14.67±4.99 years vs 13.45±3.21 years for acne; 13.73±2.85 years vs 12.96±2.39 years for hirsutism; and 13.77±2.48 years vs 12.54±3.52 years for alopecia. Regarding severity, a higher prevalence of mild (31.6%) and severe cases (13.2%) of acne was observed in the L-PCOS group compared to O-PCOS (P = 0.369, P = 0.135 respectively). Mild and moderate cases of hirsutism were nearly equally distributed across both groups: fifty percent in each of the L-PCOS and O-PCOS patients exhibited mild hirsutism ( P <10^-3), with 31.6% of the lean participants vs 35.7% of the obese showing moderate cases (P = 0.198). Alopecia presented similarly in both groups, with most cases classified as Grade 1 ( P = 0.041).

Conclusion: In conclusion, clinical hyperandrogenism is common in both lean and obese women with PCOS, with similar patterns of acne, hirsutism, and alopecia severity observed across these groups. These findings highlight the importance of comprehensive management of hyperandrogenism in all PCOS phenotypes, regardless of body weight.