OBJECTIVE: We tested the hypothesis that the three clinical phenotypes of polycystic ovary syndrome (PCOS) represent forms of the same metabolic disorder. DESIGN: Prospective cohort analysis. SETTING: University-based tertiary care. PATIENT(S): Three-hundred sixteen untreated consecutive women diagnosed as having PCOS. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Each subject underwent an evaluation of ovulatory function, body habitus, acne, and hirsutism; serum free and total testosterone (T), 17-hydroxyprogesterone (17-HP), and DHEAS; and fasting plasma glucose and insulin levels. Insulin resistance and beta-cell function were assessed using the homeostatic assessment model equation (HOMA-IR and HOMA-beta-cell, respectively). RESULT(S): The Oligo+HA+Hirsutism phenotype was present in 48% of subjects, Oligo+HA in 29%, and Oligo+Hirsutism in 23%. The three phenotypes did not differ in mean body mass index, waist-to-hip ratio, racial composition, degree of oligo-ovulation, prevalence of acne, or family history of hyperandrogenic symptomatology. However, subjects demonstrating the Oligo+HA+Hirsutism phenotype were the youngest and had the greatest degrees of hyperandrogenemia, hyperinsulinemia, and beta-cell function; patients with the Oligo+Hirsutism phenotype where the oldest and had the mildest degrees of hyperandrogenemia, hyperinsulinemia, and beta-cell function. Subjects with the Oligo+HA phenotype demonstrated intermediate degrees of hyperandrogenemia and metabolic dysfunction. CONCLUSION(S): We conclude that the three clinical phenotypes of PCOS do not represent forms of the same metabolic disorder and may be the result of varying degrees of metabolic dysfunction; greater degrees of beta-cell function and circulating insulin levels favored the development of hirsutism and frank hyperandrogenemia.
OBJECTIVE: We tested the hypothesis that the three clinical phenotypes of polycystic ovary syndrome (PCOS) represent forms of the same metabolic disorder. DESIGN: Prospective cohort analysis. SETTING: University-based tertiary care. PATIENT(S): Three-hundred sixteen untreated consecutive women diagnosed as having PCOS. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Each subject underwent an evaluation of ovulatory function, body habitus, acne, and hirsutism; serum free and total testosterone (T), 17-hydroxyprogesterone (17-HP), and DHEAS; and fasting plasma glucose and insulin levels. Insulin resistance and beta-cell function were assessed using the homeostatic assessment model equation (HOMA-IR and HOMA-beta-cell, respectively). RESULT(S): The Oligo+HA+Hirsutism phenotype was present in 48% of subjects, Oligo+HA in 29%, and Oligo+Hirsutism in 23%. The three phenotypes did not differ in mean body mass index, waist-to-hip ratio, racial composition, degree of oligo-ovulation, prevalence of acne, or family history of hyperandrogenic symptomatology. However, subjects demonstrating the Oligo+HA+Hirsutism phenotype were the youngest and had the greatest degrees of hyperandrogenemia, hyperinsulinemia, and beta-cell function; patients with the Oligo+Hirsutism phenotype where the oldest and had the mildest degrees of hyperandrogenemia, hyperinsulinemia, and beta-cell function. Subjects with the Oligo+HA phenotype demonstrated intermediate degrees of hyperandrogenemia and metabolic dysfunction. CONCLUSION(S): We conclude that the three clinical phenotypes of PCOS do not represent forms of the same metabolic disorder and may be the result of varying degrees of metabolic dysfunction; greater degrees of beta-cell function and circulating insulin levels favored the development of hirsutism and frank hyperandrogenemia.
Authors: Gwinnett Ladson; William C Dodson; Stephanie D Sweet; Anthony E Archibong; Allen R Kunselman; Laurence M Demers; Nancy I Williams; Ponjola Coney; Richard S Legro Journal: Fertil Steril Date: 2011-07 Impact factor: 7.329
Authors: Aline Ketefian; Michelle R Jones; Ronald M Krauss; Yii-Der I Chen; Richard S Legro; Ricardo Azziz; Mark O Goodarzi Journal: Fertil Steril Date: 2015-10-20 Impact factor: 7.329