Savas Karatas, Burcu Hacioglu, Gokhan Kalaycı


Objective: PCOS, which is known as a symptom complex including menstrual dysfunction (OD) and or hirsutism/androgen excess (HA),  and/or polycystic ovaries (PCOM), induces women's health damage beyond this classical criteria. Subphenotypes of PCOS have different clinical properties and criteria, and the metabolical differences between these phenotypes have not been elucidated properly. Therefore, we aimed to investigate the metabolic and endocrinological differences between these sub-phenotypes.

Materials and Methods: 63 patients with PCOS  followed by Istanbul Research and Education Hospital Endocrinology and Metabolism Department were included in the study. Patients were classified into subgroups according to phenotypes. The phenotype groups were compared according to blood glucose, lipid parameters, and serum hormone levels. MetS ratios between groups were also compared.

Results: Androgen excess/hirsutism was the most prominent character with a 95.2% (n=60) rate in this study group, and ovulatory dysfunction was the least prominent one. (n=43, 68.2%) PCOM has been detected in 50 patients (80.8%). Patients were grouped according to PCOS phenotypes. Phenotype C was the most common type, and about 65% of the patients were in this group. Triglyceride levels were statistically significantly higher in the Phenotype A group than in the Phenotype B group (p=0.03). MetS was the highest in the Phenotype A group (45.4%) and the lowest in the Phenotype C group (34.7%).

Conclusions: Phenotype C has the highest prevalence in Turkish patients with PCOS, MetS was the highest in Phenotype A, and TG and LDL cholesterol levels were higher in Phenotype A.  More studies are needed to explain these differences and their lifetime consequences.


Polycystic ovary syndrome, metabolic syndrome, hyperlipidemia, hirsutism, androgens

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Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565–92. doi: 10.1210/jc.2013-2350.

Cesta CE, Månsson M, Palm C, Lichtenstein P, Iliadou AN, Landén M. Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort. Psychoneuroendocrinology. 2016;73:196–203. doi: 10.1016/j.psyneuen.2016.08.005.

Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016;106(1):6-15. doi:10.1016/j.fertnstert.2016.05.003.

Wang Y, Hu ZP, Li MZ, Li R, Wang LN, Chen XN, et al. [Effect of hyperprolactinemia upon clinical symptoms of patients with polycystic ovary syndrome]. Zhonghua Yi Xue Za Zhi. 2009;89(37):2599-603. (Article in Chinese).

Panidis D, Tziomalos K, Misichronis G, Papadakis E, Betsas G, Katsikis I, et al. Insulin resistance and endocrine characteristics of the different phenotypes of polycystic ovary syndrome: a prospective study. Hum Reprod. 2012;27(2):541-9. doi:10.1093/humrep/der418.

Shroff R, Syrop CH, Davis W, Van Voorhis BJ, Dokras A. Risk of metabolic complications in the new PCOS phenotypes based on the Rotterdam criteria. Fertil Steril. 2007;88(5):1389-95. doi:10.1016/j.fertnstert.2007.01.032.

Elasam AN, Ahmed MA, Ahmed ABA, Sharif ME, Abusham A, Hassan B, et al. The prevalence and phenotypic manifestations of polycystic ovary syndrome (PCOS) among infertile Sudanese women: a cross-sectional study. BMC Womens Health. 2022;22(1):165. doi:10.1186/s12905-022-01762-6

Ezeh U, Yildiz BO, Azziz R. Referral bias in defining the phenotype and prevalence of obesity in polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98(6):1088-96. doi:10.1210/jc.2013-1295.

Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol. 2005;106(1):131–7.

doi: 10.1097/01.AOG.0000167408.30893.6b.

Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrin Metab. 1985;61(5):946–5. doi: 10.1210/jcem-61-5-946.

Guo F, Gong Z, Fernando T, Zhang L, Zhu X, Shi Y. The lipid profiles in different characteristics of women with PCOS and the interaction between dyslipidemia and metabolic disorder states: a retrospective study in Chinese population. Front Endocrinol (Lausanne). 2022;13:892125. doi:10.3389/fendo.2022.892125

Bizoń A, Franik G, Niepsuj J, Czwojdzińska M, Leśniewski M, Nowak A, et al. The associations between sex hormones and lipid profiles in serum of women with different phenotypes of Polycystic Ovary Syndrome. J Clin Med. 2021;10(17):3941. doi:10.3390/jcm10173941

Uk A, Decanter C, Grysole C, Keller L, Béhal H, Silva M, et al. Polycystic ovary syndrome phenotype does not have impact on oocyte morphology. Reprod Biol Endocrinol. 2022;20(1):7. doi:10.1186/s12958-021-00874-2

Wang Q, Wang H, Li P, Li X, Wang Z, Yan L, et al. Association of polycystic ovary syndrome phenotypes with adverse pregnancy outcomes after in-vitro fertilization/intracytoplasmic sperm injection. Front Endocrinol (Lausanne). 2022;13:889029. doi:10.3389/fendo.2022.889029

Wang Q, Zheng Y, Li P, Zhang G, Gao S, Wang Z, et al. Increased risk of abortion after a frozen-thawed embryo transfer in women with polycystic ovary syndrome phenotypes A and D. Sci Rep. 2022;12(1):14852. doi:10.1038/s41598-022-18704-9

Li X, Cui T, Song X, Tian W, Lin Y, Zhang H. Comparison of health-related quality of life in different polycystic ovary syndrome phenotypes: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol. 2022;271:189-94. doi:10.1016/j.ejogrb.2022.02.014



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