Characteristics of different phenotypes of polycystic ovary syndrome based on the Rotterdam criteria in the Croatian population [Osobine različitih policističnih jajnika u Hrvatskoj dijagnosticiranih po Rotterdamskim kriterijima]

Pavičić Baldani, Dinka and Škrgatić, Lana and Šimunić, Velimir and Zlopaša, Gordan and Čanić, Tomislav and Trgovčić, Iva (2013) Characteristics of different phenotypes of polycystic ovary syndrome based on the Rotterdam criteria in the Croatian population [Osobine različitih policističnih jajnika u Hrvatskoj dijagnosticiranih po Rotterdamskim kriterijima]. Collegium Antropologicum, 37 (2). pp. 477-482. ISSN 0350-6134

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Abstract

The aim of this study was to calculate the relative prevalence of all phenotypes of polycystic ovary syndrome (PCOS) and to compare them for anthropometrical, hormonal and metabolic differences according to the Rotterdam Criteria. A total of 300 women with PCOS aged 26.7 +/- 5.6 years (mean +/- SD) and 100 women aged 28.3 +/- 4.1 years (mean +/- SD) were included in a control group. Anthropometrical, hormonal and metabolic parameters were compared between the groups. The most prevalent phenotype in our population was the most severe, phenotype A (56.7%), followed by phenotype D (26.7%) and phenotype C (14.3%). Phenotype B was present in only 2.3% of patients. The four main phenotypes did not differ in age, BMI and WHR. Women with phenotypes A and C had increased levels of LH and an increased LH/FSH ratio along with elevated androgen levels compared to the other groups. Serum glucose levels did not differ between the groups studied, however, higher levels of insulin, GIR and HOMA-IR were found between phenotype A and the control group. Phenotype C PCOS or ovulatory PCOS have the same characteristics as classic PCOS, however in a more mild form, which represents a transition between the classic form and the control group. Compared to the control group, phenotype D had higher mean levels of serum testosterone (still within normal range) along with elevated LH levels and LH/FSH ratio, similar to classic PCOS. However, compared with women diagnosed with PCOS based on hyperandrogenism, oligo-ovulation and polycystic ovaries, these patients demonstrated milder endocrine and metabolic abnormalities. Therefore, from an endocrine point of view, our study supports the inclusion of a normoandrogenic anovulatory phenotype in PCOS diagnostic criteria.

Abstract in Croatian

Cilj ovog istraživanja bio je izračunati relativnu zastupljenost svih fenotipova sindroma policističnih jajnika (PCOS), dijagnosticiranih po Rotterdamskom kriteriju i usporediti njihove antropometrijske, hormonske i metaboličke razlike. Analizirano je ukupno 300 žena s PCOS-om u dobi od 26,7±5,6 godina (srednja vrijednost ± SD) i 100 žena iz kontrolne skupine u dobi od 28,3±4,1 godina (srednja vrijednost ± SD). Antropometrijski, hormonalni i metabolički parametri uspoređeni su između navedenih skupina. Najučestaliji fenotip u našoj populaciji je onaj najteži – fenotip A (56,7%), slijede ga fenotip D (26,7%) i fenotip C (14,3%). Fenotip B je bio prisutan samo u 2,3% ispitanica. Četiri glavna fenotipova nisu se razlikovala u dobi, BMI i WHR. U fenotipovima A i C nađene su povišene razine LH te omjer između LH i FSH kao i povišene vrijednosti androgena u odnosu na ostale skupine. Serumske razine glukoze nisu se značajno razlikovale između ispitivanih skupina, ali su pronađene više serumske razine inzulina, GIR i HOMA-IR između fenotipa A i kontrolne skupine. Fenotip C PCOS imao je iste karakteristike kao klasični PCOS, ali u blažem obliku i predstavlja prijelaz između klasične forme i kontrole. U usporedbi s kontrolnom skupinom, fenotip D ima višu razinu serumskog testosterona (iako u granicama normalnih vrijednosti) te povišen LH i LH / FSH omjer slično kao u klasičnom PCOS. Međutim, u usporedbi sa ženama s PCOS dijagnosticiranim na temelju hiperandrogenizma, oligoovulacije i policističnih jajnika, ove ispitanice pokazuju blaze endokrinološke i metaboličke abnormalnosti. Stoga s endokrinološkog gledišta naša studija podupire uključivanje normoandrogenog anovulatornog fenotipa PCOS-a u dijagnostičke kriterije.

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