Metabolic Profile and Insulin Resistance in Different Phenotypes of Polycystic Ovary Syndrome Attending in a Tertiary Care Hospital of Bangladesh

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various phenotypic expressions. Aims: This study was conducted to observe and compare various metabolic components in different phenotypes of PCOS and to find out the frequency of insulin resistance (IR) among them. Materials and Methods: Eighty (80) patients diagnosed as case of PCOS as per inclusion and exclusion criteria were recruited in this cross sectional observational study. Patients were categorized in 4 different phenotypes based on the presence of oligo/anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P): (i) Phenotype A (O+ H+ P), Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Demographic, anthropometric, biochemical and metabolic parameters were recorded and compared by ANOVA & Chi Square test using SPSS software version 22.0. Results: Most prevalent phenotype was phenotype A (55%) followed by phenotype D (22.5%), phenotype B (15%) & phenotype C (7.5%). Phenotype A & B had higher mean body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), total testosterone (TT), fasting insulin, triglycerides (TG) & lower HDL-cholesterol in comparison to phenotype C & D (P value 0.001, 0.000, 0.000, 0.003, 0.000, 0.005 & 0.046 respectively). Fasting plasma glucose (FPG), plasma glucose 2 hours after 75 grams oral glucose load (AG), total cholesterol & LDL-cholesterol were comparable among the phenotypes (P value 0.636, 0.829, 0.143 & 0.201 respectively). Overall frequency of IR as defined by HOMA-IR≥3.8 was 61.25%. Highest frequency of IR was found in phenotype B followed by phenotype A and least in phenotype D (IR in A, B, C & D were 72.73%, 83.33%, 33.33% & 27.28%, P 0.002). Conclusion: Phenotype A & B had higher degree of deranged metabolic parameters than other phenotypes. Insulin resistance is mostly associated with phenotype A & B and least in normoandrogenic phenotype (phenotype D).