Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups

Chang, Wendy; Knochenhauer, Eric S.; Bartolucci, Alfred A.; Azziz, Ricardo

doi:10.1016/j.fertnstert.2005.01.096

Cited by 244 publications

(166 citation statements)

References 34 publications

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“…Studies from California, University of Alabama and Iran were also in the same view. [15][16][17] These studies reported burden of hirsutism in women with PCOS in the range of 50-76%. Our findings confirm the results of another study from Andhra Pradesh.…”

Section: Discussionmentioning

confidence: 99%

Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital

Jain

Singh

et al. 2018

Int J Adv Med

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Background: Dermatologists often play a significant role in its management. Cutaneous features of hyperandrogenism in Polycystic ovarian syndrome (PCOS) have varied presentation. Aim of this study was the pattern of dermatologic manifestations in polycystic ovarian disease in northern Indian females.Methods: Patients registering for treatment of polycystic ovarian disease at Dermatology outpatients department during April 2016 to March 2017 formed the study population. Residents interviewed the study subjects at the OPD. General physical examination, systemic examination, breast and pelvic examination, along with detailed dermatological examination were conducting after taking the history. Hormonal analysis was performed after an overnight fasting using enzyme immunoassay.Results: FSH and LH levels were 5.05±1.86 IU/L and 8.14±5.21 IU/L respectively. Testosterone levels were found to be 61.01±25.32 ng/dl. DHEAS levels among them were 130.05±41.21μg/dl. Two commonest cutaneous manifestations were hirsutism and acne seen in 83.8% and 59.5% of subjects. Female pattern hair loss was seen in 45.6% females. Three most frequent hormonal abnormalities noted in our study subjects were raised L/H ratio, testosterone and LH levels seen in approximately 45%, 35% and 21% cases.Conclusions: The cutaneous manifestations of PCOS reserve a major role in its management by dermatologists. A lifestyle modification along with systemic treatment remains mainstay of treatment. Monitoring for the foreseen cardiovascular risks should start early to downgrade the morbidity.

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Section: Discussionmentioning

confidence: 99%

Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital

Jain

Singh

et al. 2018

Int J Adv Med

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“…27 However, in research settings, subdividing PCOS into more discrete categories is imperative if we are to clearly define incidence, degree of symptomology and health risks among all variants of PCOS (Table 3). [28][29][30][31][32] In the most comprehensive study aimed at evaluating the phenotypic spectrum of PCOS, DiamantiKandarakis et al showed hyperandrogenic and anovulatory phenotypes of PCOS to be the most insulin resistant-irrespective of BMI or central adiposity. 33 Their approach to elucidating differences among PCOS phenotypes involved a number of physicians and ultrasonographers working cooperatively to diagnose and evaluate a large study population.…”

Section: Elucidating the Phenotypic Spectrum Of Polycystic Ovary Syndmentioning

confidence: 99%

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

Lujan

Chizen

Pierson

2008

Journal of Obstetrics and Gynaecology Canada

143

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It is estimated that as many as 1.4 million Canadian women may be afflicted with polycystic ovary syndrome (PCOS). Although PCOS is heralded as one of the most common endocrine disorders occurring in women, its diagnosis, management, and associated long-term health risks remain controversial. Historically, the combination of androgen excess and anovulation has been considered the hallmark of PCOS. To date, while these symptoms remain the most prevalent among PCOS patients, neither is considered an absolute requisite for the syndrome. Inclusion of ultrasonographic evidence of polycystic ovaries as a diagnostic marker has substantially broadened the phenotypic spectrum of PCOS, yet much debate surrounds the validity of these newly identified milder variants of the syndrome. Difficulty in resolving the spectrum of PCOS stems from the continued use of inconsistent and inaccurate methods of evaluating androgen excess, anovulation, and polycystic ovaries on ultrasound. At present, there is no clear-cut definition of biochemical hyperandrogenemia, particularly since we depend on poor laboratory standards for measuring androgens in women. Clinical signs of hyperandrogenism are ill-defined in women with PCOS, and the diagnosis of both hirsutism and polycystic ovarian morphology remains alarmingly subjective. Lastly, there is an inappropriate tendency to assign ovulatory status solely on the basis of menstrual cycle history or poorly timed endocrine measurements. In this review, we elaborate on these limitations and propose possible resolutions for clinical and research settings. By stimulating awareness of these limitations, we hope to generate a dialogue aimed at solidifying the evaluation of PCOS in Canadian women.

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“…However, analysis of serum testosterone by commercial assays fails to identify biochemical hyperandrogenism in 20-40% of women with PCOS, while hyperandrogenism is one of the criteria on which the diagnosis is based (16,17). Moreover, female androgen insufficiency remains controversial due to the lack of reliable serum testosterone assays to define this condition (10).…”

Section: Introductionmentioning

confidence: 99%

Assessment of androgen concentration in women: liquid chromatography–tandem mass spectrometry and extraction RIA show comparable results

Janse

Eijkemans

Goverde

et al. 2011

European Journal of Endocrinology

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Objective: The measurement of serum testosterone in women is challenging due to lack of trueness, precision, and sensitivity of various available testosterone assays. Accurate assessment of testosterone in women is crucial especially in conditions associated with alleged over-or under-production of testosterone, such as in polycystic ovary syndrome (PCOS) or primary ovarian insufficiency (POI). The aim of this study was to measure and compare androgen concentrations in women with PCOS, POI, and female controls and to evaluate the performance of extraction RIA and liquid chromatographytandem mass spectrometry (LC-MS/MS) in these women. Design: Cross-sectional study. Methods: Carefully phenotyped women with POI (nZ208) or PCOS (nZ200) and 45 healthy, regularly cyclic female controls were included. Method comparison analyses were performed for total testosterone, androstenedione (AD), and DHEA, as measured by LC-MS/MS and extraction RIA. Results: All androgen levels were significantly elevated in women with PCOS compared with POI patients (P!0.05) and controls (P!0.05). Women with POI presented with similar androgen concentrations as controls, except for AD. Compared with measurements by extraction RIA, testosterone, DHEA, and AD concentrations measured by LC-MS/MS were systematically lower. However, using extraction RIA and LC-MS/MS, testosterone, DHEA, and AD measurements were shown to have good agreement as assessed by Bland-Altman analysis and intraclass correlation coefficient: 0.95 (95% confidence interval 0. 94-0.91), 0.83 (0.79-0.86), and 0.96 (0.95-0.97) respectively. Conclusions: LC-MS/MS, compared with a labor-intensive extraction RIA, shows good precision, sensitivity, and high accuracy for measuring female testosterone, DHEA, and AD concentrations under various clinical conditions. LC-MS/MS, therefore, represents a convenient and reliable assay for both clinical and research purposes, where androgen measurement in women is required. European Journal of Endocrinology 165 925-933

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Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups

Cited by 244 publications

References 34 publications

Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital

Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

Assessment of androgen concentration in women: liquid chromatography–tandem mass spectrometry and extraction RIA show comparable results

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