Evaluation of metabolic, hormonal and clinical parameters in different phenotypes of polycystic ovary syndrome: an observational study from a tertiary care centre in Eastern India

Abstract

Polycystic ovary syndrome (PCOS) is most common endocrine abnormality in women of reproductive age. Several studies of diverse populations have estimated its prevalence at 6%-10%.1‒2 They described a constellation of amenorrhea, oligomenorrhea, obesity and hirsutism in presence of polycystic ovary.3 The disorder has since been known as PCOS, although considerable changes in its definition and path physiology have occurred. The endocrine abnormalities in PCOS include hyperandrogenism of ovarian and/ or adrenal origin, which vary in clinical presentation, leading to arrested follicular development and consequently an ovulation and polycystic ovarian morphology. The majority of women with PCOS have increased luteinizing hormone (LH) secretion further worsening the hyperandrogenemic. Metabolic characteristics of PCOS include central adiposity and hyperinsulinemia with consequential insulin resistance further exacerbating hyperandrogenism. Endocrine and metabolic abnormalities seen in PCOS may vary among affected women, thus creating a heterogeneous biochemical and clinical phenotype producing difficulties in establishing a diagnosis. Most patients with PCOS have metabolic abnormalities such as insulin resistance with compensatory hyperinsulinemia, obesity, and dyslipidemia. All of these metabolic features may play a role in the development of glucose intolerance or type 2 diabetes mellitus and hypertension, thereby increasing risk of cardiovascular diseases.4 However, it is important to note that an attempt to generalize data obtained from any single ethnic group should be approached with caution. Although a true prevalence study would survey a community, our tertiary care centre represents a reference centre for women with all types of menstrual irregularities and clinical signs of androgen excess, hence this study could be a representative sample of the Eastern Indian population. As a result, the aim of this study was to report the relative prevalence of all four Rotterdam PCOS phenotypes in a tertiary care setting and compare all phenotypes for clinical, hormonal, and metabolic differences.