Abstract:

Objective To analyze the relative prevalence and the clinical and endocrine characteristics of each phenotype expressions of polycystic ovary syndrome(PCOS) according to the National Institutes of Health(NIH) and Rotterdan Consensus criteria definitions for PCOS. Methods Clinical, endocrine and metabolic data from 647 women with PCOS diagnosed according to Rotterdam criteria and NIH recommendations between Dec. 2014 and May 2015 were collected and divided into four different phenotypes. Results The severe PCOS phenotype defined as having oligo-ovulation(OO), hyperandrogenism(HA), and polycystic ovary(PCO), i.e., Group A, was the most common phenotype seen in 63.2% of the patients. Group B, defined as having OO and HA, was seen in 9% of the phenotype. Group C, defined as having HA and PCO, was seen in 15.6% and Group D, defined as having OO and PCO, was seen in 12.9%. The rate of clinical high androgen manifestation and hyperandrogenism was 87.8%, but hyperandrogenism, insulin resistance(IR) and triglyceride(TG) were significantly higher in Group A, followed by group B. Group C presented relatively milder clinical and endocrine alterations than group A and B, but had a higher luteinizing hormone/follicle-stimulating hormone(LH/FSH) than controls(P<0.05). Compared with controls, group D had similar body mass index(BMI), waist and hip circumferences, and Ferryman-Gallwey scores. Several biochemical indicator were similar across all PCOS phenotypes(P>0.05). Conclusion 1) The classification according to the revised 2003 consensus on diagnosis reflects the basic characteristics of PCOS. 2) Androgen levels are the major distinguishing endocrine feature differentiating phenotypic expressions of PCOS. Ovulatory PCOS and normoandrogenic phenotype represent the mild forms of classic PCOS, but the latter may have a different pathogenic pathway. So the choice of treatment should be individualized.

Key words: polycystic ovary syndrome, insulin resistance, phenotype, Rotterdam criteria, testosterone