Insulin resistance and endocrine characteristics of the different phenotypes of polycystic ovary syndrome: a prospective study
Abstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by oligo- or anovulation (ANOV), biochemical or clinical manifestations of hyperandrogenemia (HA) and PCOs. Four phenotypes of PCOS exist [phenotype 1 (ANOV + HA + PCO), phenotype 2 (ANOV + HA), phenotype 3 (HA + PCO) and phenotype 4 (ANOV + PCO)] but the differences between them are not well studied. We compared markers of insulin resistance (IR) and endocrine characteristics between the different PCOS phenotypes. METHODS: We prospectively studied 1212 consecutive women with PCOS and 254 BMI-matched healthy women. RESULTS: Phenotypes 1-4 were present in 48.2, 30.7, 9.7 and 11.4% of patients, respectively. BMI did not differ between the four phenotypes and controls. Both normal weight and overweight/obese women with phenotypes 1 and 2 were more insulin resistant than controls. Overweight/obese, but not normal weight, women with phenotype 4 were more insulin resistant than controls, while IR in women with phenotype 3 did not differ from controls regardless of obesity. In normal weight subjects, women with phenotypes 1 and 2 were more insulin resistant than women with phenotype 4. In overweight/obese subjects, women with phenotype 1 were more insulin resistant than women with phenotypes 2 and 3 and women with phenotype 4 were more insulin resistant than those with phenotype 3. Circulating androgens were higher in normal weight and overweight/obese PCOS patients with phenotypes 1-3 compared with those with phenotype 4, and higher in normal weight PCOS patients with phenotype 1 than in those with phenotype 2. CONCLUSIONS: Phenotype 1 is associated with more IR and more pronounced HA than phenotype 2. Phenotypes 2 and 4 with obesity, are also characterized by IR. In contrast, phenotype 3 is not associated with IR.
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The preservation of genes across diagnostic criteria suggests a more homogeneous disease and highlights the need for further research into features such as insulin resistance in women with Rotterdam-diagnosed PCOS.
“This suggests a more homogeneous disease and highlights the need for further research into features such as IR in women with Rotterdam diagnosed PCOS (Barber et al., 2007;Panidis et al., 2012).”
From Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic–hyperinsulinaemic clamp studies (2016) · cites this paper as Panidis et al., 2012
Most studies have used inaccurate measures of IR.
“However, most studies have used inaccurate measures of IR (Dewailly et al., 2006;Barber et al., 2007;Panidis et al., 2012).”
From Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic–hyperinsulinaemic clamp studies (2016) · cites this paper as Panidis et al., 2012
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- Authors
- Panidis, D., Tziomalos, K., Misichronis, G., Papadakis, E., Betsas, G., Katsikis, I., & Macut, D.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- ORCID
- Panidis, D.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-12-05
- Volume
- 27
- Issue
- 2
- Pages
- 541-549
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2159046809
- Cited by
- 155
- References
- 8
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 14 · 2023: 9 · 2022: 14 · 2021: 15 · 2020: 10 · 2019: 11 · 2018: 5 · 2017: 12 · 2016: 16 · 2015: 10 · 2014: 9 · 2013: 12 · 2012: 8
- FWCI
- 10.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- 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, PCOS phenotypes, insulin resistance, hyperandrogenemia, anovulation, obesity, body mass index, circulating androgens
- MeSH terms
- Adolescent, Adult, Anovulation, Female, Greece, Hospitals, University, Humans, Insulin Resistance, Obesity, Ovary, Phenotype, Polycystic Ovary Syndrome, Testosterone, Ultrasonography, Cohort Studies, Biomarkers, Body Mass Index, Prevalence, Hyperandrogenism, Overweight, Young Adult
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