Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes
Open accessAbstract
Objective To evaluate the clinical and endocrine differences between main polycystic ovary syndrome (PCOS) phenotypes.Design To evaluate clinical and hormone parameters in a large group of consecutive women with PCOS diagnosed according Rotterdam criteria and divided according their phenotype.Setting University department of medicine.Patient(s) Three hundred eighty-two consecutive women with PCOS and 85 ovulatory controls.Intervention(s) Evaluation of clinical and hormone parameters.Main outcome measure(s) Blood levels of gonadotropins, testosterone, sex-hormone-binding globulin, dehydroepiandrosterone sulfate, 17α-hydroxyprogesterone, progesterone, glucose, and insulin, and calculation of the free androgen index and insulin sensitivity.Result(s) The severe PCOS phenotype (hyperandrogenism, chronic anovulation, and polycystic ovaries: type I classic PCOS) was the most common phenotype in 53.9% of the patients. The phenotype of 8.9% of patients was characterized by hyperandrogenism and chronic anovulation but normal ovaries (type II classic PCOS). The two phenotypes of classic PCOS had similar clinical and endocrine characteristics, but the patients with polycystic ovaries had a higher luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio. Ovulatory PCOS was relatively common (28.8% of PCOS patients) and presented milder clinical and endocrine alterations than the classic PCOS phenotypes. The normoandrogenic phenotype was relatively uncommon. These patients had a normal body mass index, insulin sensitivity, and free androgen index but showed increased levels of LH and LH/FSH ratio.Conclusion(s) Ovulatory PCOS represents the mild form of classic PCOS, but the normoandrogenic phenotype, although part of the spectrum, may represent a different disorder or have a different pathogenetic pathway.
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Insulin resistance and hyperinsulinemia are intrinsic to polycystic ovary syndrome in adults and adolescents, whether lean or obese.
“Insulin resistance and hyperinsulinemia are intrinsic to PCOS in adults and adolescents, lean or obese.”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [12]
With one published exception, current definitions of polycystic ovary syndrome in adolescent or adult women do not include insulin resistance or hyperinsulinemia as a diagnostic criterion.
“With the exception of one published recommendation, none of the current definitions of PCOS in adolescent or adult women include insulin resistance/hyperinsulinemia as a diagnostic criterion [1, 10-12, 18, 19, 112]”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [12]
Hyperinsulinemia is believed to worsen hyperandrogenism and the reproductive and metabolic manifestations of polycystic ovary syndrome in adolescents.
“Hyperinsulinemia is believed to exacerbate the hyperandrogenism and the reproductive and metabolic manifestations of PCOS in adolescents.”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [12]
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- Authors
- Guastella, E., Longo, R. A., & Carmina, E.
- Affiliations
- University of Palermo (IT)
- Corresponding author
- Carmina, Enrico
- ORCID
- Carmina, Enrico
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 94
- Issue
- 6
- Pages
- 2197-2201
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2129451889
- Cited by
- 205
- References
- 23
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 14 · 2023: 13 · 2022: 15 · 2021: 22 · 2020: 6 · 2019: 5 · 2018: 9 · 2017: 11 · 2016: 16 · 2015: 15 · 2014: 9 · 2013: 16 · 2012: 19
- FWCI
- 17.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, PCOS phenotypes, hyperandrogenism, chronic anovulation, LH/FSH ratio, insulin sensitivity, free androgen index, sex hormone-binding globulin, dehydroepiandrosterone sulfate, insulin resistance, Rotterdam criteria
- MeSH terms
- Adult, Androgens, Endocrine System, Female, Follicle Stimulating Hormone, Humans, Luteinizing Hormone, Phenotype, Polycystic Ovary Syndrome, Retrospective Studies, Sex Hormone-Binding Globulin, Prevalence, Case-Control Studies, Hyperandrogenism, Dehydroepiandrosterone Sulfate, Young Adult
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