Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome
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CONTEXT/OBJECTIVE: Current diagnostic criteria for polycystic ovary syndrome (PCOS) have generated distinct PCOS phenotypes, based on the different combinations of diagnostic features found in each patient. Our aim was to assess whether either each single diagnostic feature or their combinations into the PCOS phenotypes may predict insulin resistance in these women. PATIENTS/DESIGN: A total of 137 consecutive Caucasian women with PCOS, diagnosed by the Rotterdam criteria, underwent accurate assessment of diagnostic and metabolic features. Insulin sensitivity was measured by the glucose clamp technique. RESULTS: Among women with PCOS, 84.7% had hyperandrogenism, 84.7% had chronic oligoanovulation, and 89% had polycystic ovaries. According to the individual combinations of these features, 69.4% of women had the classic phenotype, 15.3% had the ovulatory phenotype, and 15.3% had the normoandrogenic phenotype. Most subjects (71.4%) were insulin resistant. However, insulin resistance frequency differed among phenotypes, being 80.4%, 65.0%, and 38.1%, respectively, in the 3 subgroups (P < .001). Although none of the PCOS diagnostic features per se was associated with the impairment in insulin action, after adjustment for covariates, the classic phenotype and, to a lesser extent, the ovulatory phenotype were independently associated with insulin resistance, whereas the normoandrogenic phenotype was not. Metabolic syndrome frequency was also different among phenotypes (P = .030). CONCLUSIONS: There is a scale of metabolic risk among women with PCOS. Although no single diagnostic features of PCOS are independently associated with insulin resistance, their combinations, which define PCOS phenotypes, may allow physicians to establish which women should undergo metabolic screening. In metabolic terms, women belonging to the normoandrogenic phenotype behave as a separate group.
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Hyperandrogenic PCOS phenotypes show an increased level of insulin resistance and metabolic complications.
“Hyperandrogenic PCOS phenotypes show an increased level of insulin resistance and metabolic complications [25].”
From Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism (2022) · cites this paper as [25]
Previous studies found that PCOS women have a significant reduction in insulin sensitivity compared to BMI and age-matched controls.
“Previous studies found that PCOS women have a significant reduction in insulin sensitivity compared to BMI and age-matched controls [25,39].”
From Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism (2022) · cites this paper as [25]
Normo-androgenic PCOS (phenotype D) have a lower risk of metabolic disorders.
“In contrast, normo-androgenic PCOS (phenotype D) have a lower risk of metabolic disorders [25].”
From Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism (2022) · cites this paper as [25]
The incidence of insulin resistance differs according to PCOS phenotype: it is present more often in the classic phenotype (80.4%) than in the ovulatory (65.0%) and normoandrogenic (38.1%) phenotypes.
“It has been shown that IR is present more often in the classic phenotype (80.4%) than in the ovulatory (65.0%) and normoandrogenic (38.1%) [34].”
From The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome (2022) · cites this paper as [34]
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- Authors
- Moghetti, P., Tosi, F., Bonin, C., Di Sarra, D., Fiers, T., Kaufman, J.-M., Giagulli, V. A., Signori, C., Zambotti, F., Dall'Alda, M., Spiazzi, G., Zanolin, M. E., & Bonora, E.
- Affiliations
- Endocrinology, Diabetes and Metabolism (P.M., F.T., D.D.S., F.Z., M.D., G.S., E.B.), 37126 Verona, Italy
- University of Verona (IT)
- Laboratory for Hormonology (T.F., J.-M.K.), B-9000 Ghent, Belgium
- Ghent University Hospital (BE)
- Unit of Metabolic Diseases and Endocrinology (V.A.G.), Conversano Hospital, 70014 Conversano, Italy
- Corresponding author
- Moghetti, Paolo
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2013-04-01
- Volume
- 98
- Issue
- 4
- Pages
- E628-E637
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1984323756
- Cited by
- 262
- References
- 74
- Citations by year
- 2026: 17 · 2025: 22 · 2024: 21 · 2023: 24 · 2022: 20 · 2021: 32 · 2020: 16 · 2019: 19 · 2018: 18 · 2017: 11 · 2016: 10 · 2015: 19 · 2014: 21 · 2013: 11
- FWCI
- 24.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- Funders
- Università degli Studi di Verona
- 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, insulin resistance, PCOS phenotypes, hyperandrogenism, chronic anovulation, metabolic syndrome, Rotterdam criteria, insulin sensitivity, metabolic screening
- MeSH terms
- Adult, Anovulation, Blood Glucose, Female, Humans, Individuality, Insulin, Insulin Resistance, Phenotype, Polycystic Ovary Syndrome, Testosterone, Hyperandrogenism, Metabolic Syndrome, Young Adult
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