Polycystic ovary syndrome (PCOS) has a heterogeneous phenotypic distribution that can potentially lead to variations in metabolic repercussions. A cross-sectional study was conducted with 372 women of reproductive age (146 of whom were ovulatory and 226 with PCOS) divided into groups according to PCOS phenotype: (i) complete phenotype involving menstrual irregularity (MI), hyperandrogenism (H), and ultrasound (US) findings of polycystic ovaries (132 patients); (ii) MI + H (18 patients); (iii) MI + US (51 patients); and (iv) H + US (25 patients). The frequencies of metabolic syndrome (MetS) were 45.4%, 38.9%, 33.3%, 36%, and 8.2% for the MI + H + US, MI + H, MI + US, H + US, and control groups (P < .01), respectively. In logistic regression, body mass index ([BMI] odds ratio [OR]: 1.1, 95% confidence interval [CI] 1.1-1.2) and the association of the complete phenotype with MI + H (OR: 5.8 CI95% [2.2-15.8) were independent predictors of the occurrence of MetS. The defining characteristics of MetS were more frequently found in women with PCOS than in controls, regardless of the phenotype (P < .01 for each variable). In conclusion, the frequency of MetS is similar for various PCOS phenotypes among young Brazilian women from the Southeast region of the country, although only BMI and the presence of MI + H, regardless of the presence of US findings, were more predictive of the development of MetS.
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Belosi C, Selvaggi L, Apa R, et al. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Hum reprod. 2006;21(12):3108–3115.
Wiltgen D, Spritzer PM. Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes. Fertil Steril. 2010;94(6):2493–2496.
Goverde AJ, van Koert AJ, Eijkemans MJ, et al. Indicators for metabolic disturbances in anovulatory women with polycystic ovary syndrome diagnosed according to the Rotterdam consensus criteria. Hum Reprod. 2009;24(3):71–717.
Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod. 2009;15(4):477–488.
Dokras A, Jagasia DH, Maifeld M, Sinkey CA, VanVoorhis BJ, Haynes WG. Obesity and insulin resistance but not hyperandrogenism mediates vascular dysfunction in women with polycystic ovary syndrome. Fertil Steril. 2006;86(6):1702–1709.
de Zegher F, Ibanez L. Prenatal growth restraint followed by catch-up of weight: a hyperinsulinemic pathway to polycystic ovary syndrome. Fertil Steril. 2006;86(suppl 1):S4–S5.
Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210–1217.
Dewailly D, Catteau-Jonard S, Reyss AC, Leroy M, Pigny P. Oligoanovulation with polycystic ovaries but not overt hyperandrogenism. J Clin Endocrinol Metab. 2006;91(10):3922–3927.
Kauffman RP, Baker TE, Baker VM, DiMarino P, Castracane VD. Endocrine and metabolic differences among phenotypic expressions of polycystic ovary syndrome according to the 2003 Rotterdam consensus criteria. Am J Obstet Gynecol. 2008;198(6):670.e1–7.
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–2752.
Welt CK, Gudmundsson JA, Arason G, et al. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features. J Clin Endocrinol Metab. 2006;91(12):4842–4848.
Zhang HY, Zhu FF, Xiong J, Shi XB, Fu SX. Characteristics of different phenotypes of polycystic ovary syndrome based on the Rotterdam criteria in a large-scale Chinese population. BJOG. 2009;116(12):1633–1639.
Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol. 2006;154(1):141–145.
Soares EM, Azevedo GD, Gadelha RG, Lemos TM, Maranhão TM. Prevalence of the metabolic syndrome and its components in Brazilian women with polycystic ovary syndrome. Fertil Steril. 2008;89(3):649–655.
Guo M, Chen ZJ, Macklon NS, et al. Cardiovascular and metabolic characteristics of infertile Chinese women with PCOS diagnosed according to the Rotterdam consensus criteria. Reprod Biomed Online. 2010;21(4):572–580.
The Rotterdam ESHRE/ASRM—Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41–47.
Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–1447.
Friedewald WT, Levy IR, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–2752.
Griffin IJ, Cole TJ, Duncan KA, Hollman AS, Donaldson MD. Pelvic ultrasound measurements in normal girls. Acta Paediatr. 1995;84(5):536–543.
Kahn R, Buse J, Ferrannini E, Stern M; American Diabetes Association; European Association for the Study of Diabetes. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005;28(9):2289–2304.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419.
Geloneze B, Repetto EM, Geloneze SR, Tambascia MA, Ermetice MN. The threshold value for insulin resistance (HOMA-IR) in an admixtured population IR in the Brazilian Metabolic Syndrome Study. Diabetes Res Clin Pract. 2006;72(2):219–220.
Glueck CJ, Papanna R, Wang P, Goldenberg N, Sieve-Smith L. Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome. Metabolism. 2003;52(7):908–915.
Apridonidze T, Essah P, Iuorno M, Nestler JE. Prevalence and characteristics of metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(4):1929–1935.
Carmina E, Lobo RA. Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Fertil Steril. 2004;82(3):661–665.
Melo AS, Vieira CS, Barbieri MA, et al. High prevalence of polycystic ovary syndrome in women born small for gestational age. Hum Reprod. 2010;25(8):2124–2131.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–3421.
Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA. 2002;287(3):356–359.
Ehrmann DA, Liljenquist DR, Kasza K, et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(1):48–53.
Soares GM, Vieira CS, Martins WP, et al. Increased arterial stiffness in nonobese women with polycystic ovary syndrome (PCOS) without comorbidities: one more characteristic inherent to the syndrome? Clin Endocrinol (Oxf). 2009;71(3):406–411.
Castelo-Branco C, Steinvarcel F, Osorio A, Ros C, Balasch J. Atherogenic metabolic profile in PCOS patients: role of obesity and hyperandrogenism. Gynecol Endocrinol. 2010;26(10):736–742.
Pasquali R. Obesity and androgens: facts and perspectives. Fertil Steril. 2006;85(5):1319–1340.
Wild RA, Carmina E, Diamanti-Kandarakis E, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95(5):2038–2049.
Elting MW, Korsen TJM, Bezemer PD, Schoemaker J. Prevalence of diabetes mellitus, hypertension and cardiac complaints in a follow-up study of a Dutch PCOS population. Hum Reprod. 2001;16(3):556–560.
Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2010;16(4):347–363.
DeFronzo RA, Tobin JD, Andreas R. Glucose clamp technique: a method for quantifying insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 1979;85(1):2402–2410.
Straczkowski M, Stepień A, Kowalska I, Kinalska I. Comparison of simple indices of insulin sensitivity using the euglycemic hyperinsulinemic clamp technique. Med Sci Monit. 2004; 10(8):480–484.
Radikova Z. Assessment of insulin sensitivity/resistance in epidemiological studies. Endocr Regul. 2003;37(3):189–194.
Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Utility, limitation, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab. 2007;92(2):405–413.
Legro RS, Schlaff WD, Diamond MP, et al. Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism. J Clin Endocrinol Metab. 2010;95(12):5305–5313.
Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update. 2003;9(6):505–514.
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Melo, A.S., Vieira, C.S., Romano, L.G.M. et al. The Frequency of Metabolic Syndrome is Higher Among PCOS Brazilian Women With Menstrual Irregularity Plus Hyperandrogenism. Reprod. Sci. 18, 1230–1236 (2011). https://doi.org/10.1177/1933719111414205
- polycystic ovary syndrome
- metabolic syndrome
- insulin resistance
- PCOS phenotypes