Abstract

Abstract Background Depending on metabolic profile, two different PCOS phenotypes may be distinguished- the metabolic phenotype related to insulin resistance (IR) and the reproductive one, with persistent insulin sensitivity. Hyperandrogenemia, the main feature of PCOS, leads to increased visceral fat and muscle masses and thus to lower insulin sensitivity. In turn, IR leads to metabolic consequences and hormonal imbalance. Moreover, vitamin D deficiency, which is common in PCOS patients, is also associated with insulin resistance. Aim To compare the hormonal profiles and vitamin D status in women with PCOS depending on insulin sensitivity status. Materials and methods One thousand three hundred women with PCOS, aged 18 to 40, were recruited. The patients were divided into two groups depending on their insulin sensitivity status. Metabolic and hormonal parameters were assessed in subjects from each group. Blood samples were collected between the second and the sixth day of the menstrual cycle (follicular phase)for the quantification of hormonal parameters using the electrochemiluminescence immunoassay (ECLIA) methods or colorimetry. Results Patients with insulin resistance have a significantly higher concentration of DHEAS and TSH, higher Free Androgen Index, and significantly lower vitamin D concentration. Moreover, cortisol and estradiol concentrations are higher and prolactin is lower in patients with IR, but the differences are not statistically significant. There are no significant differences in the prevalence of Hashimoto disease between patients with IR and patients with persistent insulin sensitivity. Conclusions Metabolic phenotype of PCOS is associated with higher androgen concentration and higher TSH concentration compared to reproductive phenotype. Moreover, patients with PCOS and IR often have vitamin D deficiency compared to patients with persistent insulin sensitivity. Therefore the supplementation of vitamin D and regular TSH measurements are important in patients with metabolic PCOS phenotype. Presentation: No date and time listed

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