Polycystic Ovarian Morphology is Associated with Hyperandrogenemia and Insulin Resistance in Women with Polycystic Ovary Syndrome (PCOS)

Neoklis Ag,Anastasia Ka,Adonakis Gl ,Vassilios Papadopoulos ,Aikaterini Damianaki ,George Decavalas ,Georgios K Markantes ,Nikolaos Dr ,D Panidis

doi:10.4172/2157-7536.1000169

Neoklis Ag, Anastasia Ka + Show 7 more

Open Access

https://doi.org/10.4172/2157-7536.1000169

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Abstract

Objectives: The aim of the present study was to evaluate the impact of polycystic ovarian morphology in the hormonal and metabolic features of the classical phenotypes of PCOS. Design: The study included 1275 Caucasian women with PCOS with a mean age of 24.25 ± 5.79 years and a mean BMI of 26.80 ± 7.03 kg/m2. Diagnosis of PCOS was based on the 2003 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus criteria. Two phenotypes, matched for age and BMI were compared: Phenotype I (n=620) which included PCOS women with biochemical hyperandrogenemia and/or clinical hyperandrogenemia, chronic anovulation and polycystic ovarian morphology on ultrasound (PCO). Phenotype II (n=400) which included PCOS women with biochemical hyperandrogenemia and/or clinical hyperandrogenemia and chronic anovulation, without PCO. These phenotypes were further subdivided in normal weight and obese PCOS women. Results: PCOS women of Phenotype I had higher LH/FSH ratio (p<0.001), higher Testosterone (p<0.01), Δ4 Androstenedione (p<0.001) and 17-OH progesterone levels (p<0.001), and higher Free Androgen Index (FAI) values (p<0.01) compared to Phenotype II. With the exception of fasting glucose levels, all other indices of insulin resistance (fasting insulin, fasting glucose/insulin ratio, QUICKI and HOMA2IR) document an association between Phenotype I and greater insulin resistance in overweight/obese PCOS women. Conclusions: In conclusion, in classical phenotypes of polycystic ovary syndrome (PCOS), polycystic ovarian morphology is associated with more severe hyperandrogenemia and deranged LH/FSH ratio. In overweight/obese PCOS subjects, PCO is positively correlated with insulin resistance.

Highlights

Polycystic ovary syndrome (PCOS) is the commonest endocrine disease of reproductive-aged women [1]
In conclusion, in "classical" phenotypes of polycystic ovary syndrome (PCOS), polycystic ovarian morphology is associated with more severe hyperandrogenemia and deranged luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio
In overweight/obese PCOS subjects, PCO is positively correlated with insulin resistance

Summary

Introduction

Polycystic ovary syndrome (PCOS) is the commonest endocrine disease of reproductive-aged women [1]. According to the National Institute of Health (NIH) criteria (1990), PCOS is diagnosed upon the concurrent presence of hyperandrogenism and/or hyperandrogenemia and menstrual dysfunction, with other known disorders excluded [2]. These criteria define the so called “classical” phenotypes of the syndrome. A broader definition was suggested by the Rotterdam conference, sponsored by the ESHRE/ASRM in 2003, according to which, PCOS could be defined when at least two out of the following three features are present: oligo-anovulation, clinical and/or biochemical hyperandrogenemia and polycystic ovarian morphology on ultrasound [3]. Additional milder phenotypes, characterized by the presence of either hyperandrogenemia and polycystic ovarian morphology (PCO) or anovulation and PCO have been included in PCOS, according to the revised ESHRE/ASRM criteria [4,5], still phenotypes that include biochemical hyperandrogenemia and chronic anovulation (“classic” PCOS) appear to be the most severely affected with respect to androgen levels, insulin resistance and obesity [5,6,7]

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