Should All Women with Polycystic Ovary Syndrome Be Screened for Metabolic Parameters?: A Hospital-Based Observational Study

Abstract

This hospital-based observational study aims to estimate differences in metabolic abnormalities between different polycystic ovary syndrome (PCOS) phenotypes and their distribution characteristics. The prevalence of metabolic abnormalities among different PCOS phenotypes, including diabetes mellitus (DM), metabolic syndrome (MS), pre-diabetes mellitus (pre-DM), insulin resistance (IR) and dyslipidemia were compared. A total of 2436 women who were ≥18 years old and who were hospitalized in Sun Yat-Sen University affiliated hospital from 1998 to 2015 in GuangZhou, China, were included in this study. PCOS phenotypes were recorded according to the 2003 Rotterdam criteria, including the polycystic ovary morphology (PCO), hyperandrogenism (HA) and ovulation dysfunction (OD) phenotype (PCO+HA+OD); the ovulation phenotype (PCO+HA); the non-PCO phenotype (HA+OD); and the non-HA phenotype (PCO+OD). Notably, 56% of the patients had the classic phenotype (PCO+HA+OD). Importantly, there was no significant difference in the prevalence of metabolic abnormalities or the distribution characteristics of the metabolic abnormalities among these four PCOS phenotypes. Our study supports the notion that metabolic abnormalities and the distribution characteristics of metabolic abnormalities should not be used to distinguish among the various clinical PCOS phenotypes.

Prevalence of metabolic disturbances among women with polycystic ovary syndrome in different regions of Brazil

“…In our study, the prevalence of insulin resistance in Brazil varied from 39.6% to 55.0%. It was lower than that of data from the US population (64%), 40 and higher than the prevalence in the Chinese population (28.5%–38.5%) 11 . However, it was similar to that obtained by the Italian (52.1%) and Indian (41%) studies 15,19 …”

“…[41][42][43] In other population studies, the prevalence of low HDL-C varied from 29.3% to 97.3%, 11,[17][18][19] being lowest in the PCOS population in Argentina 18 and highest in the Indian PCOS population. 17 Regarding increased triglycerides, international data on triglycerides exhibited a prevalence of 9.6%-66.6% in women with PCOS, 11,[17][18][19] with Italian Hyperandrogenemia associated with increased sympathetic drive, previously described in PCOS, 44,45 contributed to an increased risk of hypertension in this syndrome. In accordance with this, previous studies have found that the prevalence of hypertension in PCOS ranges from 3.8% to 40.2%, 15,18,20,46 being higher in the presence of hyperandrogenism.…”

“…This is consistent with data found in the Chinese study. 11 However, in the Melo et al study, 16 phenotypes A and B were associated with a higher prevalence of metabolic syndrome, while in the Tavares and Rego Barros study, 21 phenotype C had the lowest prevalence. The latter study had a small sample size for phenotypes B and C, and used different diagnostic criteria for metabolic syndrome than the other Brazilian studies.…”

“…However, variation in the combination of these factors is also heterogeneous among women with PCOS 6,7 . Although controversial, 8–11 some studies have shown that phenotypes of hyperandrogenic PCOS may be associated with a higher metabolic and cardiovascular risk profile than the normoandrogenic phenotype 12–16 . Hence, characterizing the prevalence of metabolic syndrome in distinct PCOS phenotypes of our population adds to this discussion and it is important in identifying a population to target for preventive and personalized treatments.…”

Diagnosis and follow-up of type 2 diabetes in women with PCOS: a role for OGTT?

“…Women fulfilling the National Institute of Health (NIH) criteria for PCOS could have higher metabolic risk than patients with milder phenotypes (68) and metabolic disturbances were more pronounced in women with PCOS and hyperandrogenism as compared to women with no hyperandrogenism (69). However, high testosterone and PCOS phenotype did not predict glycemic status in three studies, two recent Nordic studies (3,11) and one Chinese study (70). It is important to recognize that BMI differed between different Rotterdam phenotypes (11).…”