CoChat
Sign Up
Cited by 5Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

The association between the follicular distribution pattern of polycystic ovaries and metabolic syndrome development in patients with polycystic ovary syndrome a prospective cohort study

Open access
Pourkhani, Zahra, Jahanian Sadatmahalleh, Shahideh, Moini, Ashraf, Nasiri, Malihe·2025·Scientific Reports
DOI 10.1038/s41598-025-89745-zPMC PMC11822200
Open this paper in CoChat — free account

Abstract

Since a limited number of studies have investigated the different pattern of follicular distribution in the ovaries of PCOS patient, the present study was designed to evaluate the relationship of the follicular distribution pattern (FDP) in the ovaries and MetS as well as insulin resistance index, the sex hormones levels and menstrual status in women with PCOS diagnosis. This prospective study was carried out at Arash Women's Hospital (Tehran, Iran) from September 2023 to June 2024. All PCOS women who were referred for any gynecological examination were screened. The ultrasound images of polycystic ovarian morphology ovaries were further classified as having a peripheral cystic pattern (PCP) if the follicles were arranged at the periphery of the ovary, or a general cystic pattern (GCP) if the follicles were dispersed heterogeneously throughout the ovarian stroma. The association between the ultrasound follicular distribution patterns and the reproductive items (menstrual status, sex hormones levels and Ferriman-Gallwey score), as well as the metabolic features (insulin resistance index and the MetS rate) were evaluated. Of the 108 PCOS patients evaluated during the study, 51 patients were classified in the PCP ovaries group and 57 patients in the GCP ovaries group. There was no statistically significant difference in terms of women' age, body mass index, waist circumstance, and the Ferriman-Gallwey score between groups. The frequency of cases with oligo menorrhea in the PCP group was significantly higher than the GCP group (P = 0.006). However, no significant relationship was found between FDP and the baseline serum hormonal levels, total testosterone, and insulin resistance index as well as MetS rate and any components of MetS. No association was identified between the FDP and the rate of MetS, as well as other sex hormones, glucose, and lipids profiles in patients with PCOS; however, the PCP ovaries was linked to menstrual irregularities.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1038/s41598-025-89745-z

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Insulin resistance is a fundamental component of the pathophysiology of PCOS, and its effects are exacerbated by obesity.

    “IR is recognized as a fundamental component of the pathophysiology of PCOS, and its effects are exacerbated by obesity [22,23].”

    From Visceral and Dysfunctional Adiposity Indices as Predictors of Insulin Resistance and Metabolic Syndrome in Women with Polycystic Ovary Syndrome: A Cross-Sectional Study (2025) · cites this paper as [23]

    The Discussion (page unavailable) reports insulin resistance as a proposed driving force behind PCOS, supporting its importance to PCOS pathophysiology. The Introduction and Discussion discuss obesity in relation to metabolic syndrome, but do not say that obesity exacerbates the effects of insulin resistance in PCOS. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 30

  1. [1]Clayton, R. et al. How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? Clin. Endocrinol.37(2), 127–134 (1992). 1395063
  2. [2]Fulghesu, A. M. & Fulghesu, B. Good Practice in Pediatric and Adolescent Gynecology (Springer, 2018).
  3. [3]Dewailly, D. J. B. P. Diagnostic criteria for PCOS: is there a need for a rethink? Obstet. RC Gynecol.37, 5–11 (2016). 27151631
  4. [4]Kiconco, S., Teede, H. J., Azziz, R., Norman, R. J. & Joham, A. E.The need to reassess the diagnosis of polycystic ovary syndrome (PCOS): a review of diagnostic recommendations from the international evidence-based guideline for the assessment and management of PCOS. Semin. Reprod. Med. (2021). 34404096
  5. [5]Gyliene, A., Straksyte, V. & Zaboriene, I. J. O. M. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome. Open Med.17(1), 1114–1122 (2022). PMC9210988 35799603
  6. [6]Battaglia, C. The role of Ultrasound and Doppler Analysis in the Diagnosis of Polycystic Ovary Syndrome 225–232 (Wiley Online Library, 2003). 12942492
  7. [7]Mills, G., Goorah, B., Elizur, S. E., Son, W-Y. & Dahan, M. H. Relationship between the follicular distribution pattern of polycystic ovaries and the degree of menstrual disturbance and serum sex steroid levels. Turkish J. Obstet. Gynecol. 19 (3), 215 (2022). PMC9511927 36149262 · DOI
  8. [8]Zhu, R-Y., Wong, Y-C., Yong, E-L-J-B-P. & Obstetrics, R. C. Sonographic evaluation polycystic pvaries. Gynecology37, 25–37 (2016). 27118252
  9. [9]Balen, A. H., Laven, J. S., Tan, S. L. & Dewailly, D. J. H. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum. Reprod Update9(6), 505–514 (2003). 14714587
  10. [10]Brink, H. V. & Lujan, M. E. Ovarian Ultrasonography in Polycystic Ovary Syndrome (Springer, 2024)
  11. [11]Takahashi, K., Ozaki, T., Okada, M., Uchida, A. & Kitao, M. Relationship between ultrasonography and histopathological changes in polycystic ovarian syndrome. Hum. Reprod. 9 (12), 2255–2258 (1994). 7714140 · DOI
  12. [12]Alviggi, C. et al. The distribution of Stroma and Antral follicles differs between insulin-resistance and hyperandrogenism-related polycystic ovarian syndrome. Front. Endocrinol.;8, 117 (2017). PMC5449504 28620353
  13. [13]Christ, J. P. et al. Ultrasound features of polycystic ovaries relate to degree of reproductive and metabolic disturbance in polycystic ovary syndrome. Fertil. Steril. 103 (3), 787–794 (2015). 25572873 · DOI
  14. [14]Fahed, G. et al. Metabolic syndrome: updates on pathophysiology and management in 2021. Int. J. Mol. Sci.23(2), 786 (2022). PMC8775991 35054972
  15. [15]Beydoun, H. A. et al. Patterns of bariatric surgeries among US women diagnosed with polycystic ovarian syndrome. J. Women’s Health29(4), 585–595 (2020). PMC7366265 32077783
  16. [16]Fu, L., Xie, N., Qu, F., Zhou, J. & Wang, F. J. R. S. The association between polycystic ovary syndrome and metabolic syndrome in adolescents: a systematic review and meta-analysis. Reprod. Sci.30(1), 28–40 (2023). PMC9810687 35107824
  17. [17]Sipahi, M. et al. Is ovarian volume a good predictor to determine metabolic syndrome development in polycystic ovary patients. J. Obstet. Gynaecol. 39 (3), 372–376 (2019). 30744441 · DOI
  18. [18]Mansour, A. et al. Ovarian volume, not follicle count, is independently associated with androgens in patients with polycystic ovary syndrome. BMC Endocrine Disord.22(1), 298 (2022). PMC9714143 36456925
  19. [19]Bahadur, A. et al. Prevalence of metabolic syndrome among women with different PCOS phenotypes–a prospective study. Gynecol. Endocrinol.37(1), 21–25 (2021). 32516071
  20. [20]Krentowska, A. & Kowalska, I. J. D. M. R. Reviews: metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome. Diabetes/Metabol. Res. Rev. 38(1), e3464 (2022). 33988288
  21. [21]Revised 2003 consensus. On diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril. 81 (1), 19–25 (2004). 14711538 · DOI · Paper page
  22. [22]Kahraman, F. C., Erdoğan, S. S. J. A. D. & Alergologii, A. P. D. i. Grading of hirsutism: a practical approach to the modified Ferriman-Gallwey scoring system. Adv. Dermatol. Allergol.39(4), 744–748 (2021). PMC9454347 36090715
  23. [23]Christ, J. P. & Cedars, M. I. J. D. Current guidelines for diagnosing PCOS. Diagnostics13(6), 1113 (2023). PMC10047373 36980421
  24. [25]Athyros, V. G., Ganotakis, E. S. & Elisaf, M. Mikhailidis DPJCmr, opinion. The prevalence of the metabolic syndrome using the National Cholesterol Educational Program and International Diabetes Federation definitions. 21(8), 1157–1159 (2005). 16083523
  25. [26]AZIZI, F. et al. Appropriate waist circumference cut-off points among Iranian adults: the first report of the Iranian National Committee of Obesity (2010). 20433230
  26. [27]Reid, S. P. et al. Ovarian morphology is associated with insulin resistance in women with polycystic ovary syndrome: a cross sectional study. Fertil. Res. Pract.3, 1–7 (2017). PMC5450099 28620546
  27. [28]Karee, M., Gundabattula, S. R., Sashi, L., Boorugu, H. & Chowdhury, A. Prevalence of metabolic syndrome in women with polycystic ovary syndrome and the factors associated: a cross sectional study at a tertiary care center in Hyderabad, south-eastern India. Diabetes Metabolic Syndrome 14 (4), 583–587 (2020). 32416528 · DOI
  28. [29]Dey, R., Mukherjee, S., Roybiswas, R., Mukhopadhyay, A. & Biswas, S. C. Association of metabolic syndrome in polycystic ovarian syndrome: an observational study. J. Obstet. Gynaecol. India61(2), 176–181. 10.1007/s13224-011-0020-0 (2011). · DOI
  29. [30]Mandrelle, K. et al. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic in a tertiary care hospital in south India. J. Hum. Reprod. Sci. 5 (1), 26–31 (2012). 22870011 PMC3409916 · DOI
  30. [31]Sharma, S. & Majumdar, A. Prevalence of metabolic syndrome in relation to body mass index and polycystic ovarian syndrome in Indian women. J. Hum. Reprod.Sci. 8 (4), 202–208 (2015). 26752855 PMC4691971 · DOI

Cited by

Sorted by citations

Authors
Pourkhani, Z., Jahanian Sadatmahalleh, S., Moini, A., & Nasiri, M.
Affiliations
  • Tarbiat Modares University (IR)
  • Royan Institute (IR)
  • Shahid Beheshti University of Medical Sciences (IR)
ORCID
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2025-02-12
Volume
15
Issue
1
Pages
5284-5284
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-025-89745-z
PMC
PMC11822200
OpenAlex
W4407392253
Cited by
5
References
2
Citations by year
2026: 2 · 2025: 3
FWCI
4.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
Keywords
polycystic ovary syndrome, metabolic syndrome, insulin resistance, sex hormones, testosterone, menstrual irregularity, oligomenorrhea, Ferriman-Gallwey score, ovarian morphology
MeSH terms
Adult, Female, Ovarian Follicle, Humans, Insulin Resistance, Iran, Ovary, Polycystic Ovary Syndrome, Prospective Studies, Ultrasonography, Body Mass Index, Metabolic Syndrome, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review