Metabolic aspects of different phenotypes of polycystic ovary syndrome: Iranian PCOS Prevalence Study

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Abstract
Summary: Objective: To compare insulin resistance (IR) and metabolic characteristics of different phenotypes of polycystic ovary syndrome (PCOS) and healthy controls in a representative sample of reproductive‐aged Iranian women.Design: Cross‐sectional community‐based study.Patients: Of 915 participants, 136 met Rotterdam criteria for PCOS and were divided in four subgroups: ovulatory dysfunction with polycystic ovaries (Anovu + PCO), hyperandrogenism with PCO (HA + PCO), hyperandrogenism with ovulatory dysfunction (HA + Anovu) and full Rotterdam (HA + Anovu + PCO). Also 423 subjects served as normal controls, and the rest of participants were analysed as isolated HA, Anovu or PCO subgroups.Measurements: Anthropometric measures, biochemical parameters and IR were compared between different groups. IR was defined using the homeostatic model assessment‐IR (HOMA‐IR).Results: Overall prevalence of IR in PCOS and normal women were 26·5% and 23·9%, respectively (P = 0·03). After age and BMI adjustment, there was no difference regarding metabolic characteristics between different PCOS phenotypes. Also metabolic characteristics, fasting insulin and HOMA‐IR were comparable in PCOS subjects with hyperandrogenism and the nonhyperandrogenic phenotype (Anovu + PCO). In regression analysis, only overweight and obesity (BMI ≥ 25 kg/m2) had an independent association with IR (OR: 2·49, CI: 1·06–5·82, P = 0·03).Conclusions: In a representative sample of an Iranian PCOS population, there is no significant difference between different PCOS phenotypes or between PCOS women and normal subjects regarding their metabolic characteristics. These findings suggest that overall metabolic screening may not always be required for all women diagnosed with PCOS. Larger‐scale population‐based studies are needed to further assess these issues.

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