Research Progress on the Correlation between Endocrine Abnormalities in Different Phenotypes of Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)作为高度异质性的妇科内分泌疾病，其不同表型(Rotterdam分型A/B/C/D型)的内分泌紊乱特征存在显著差异，直接影响疾病进程与治疗效果。本文聚焦高雄激素、代谢异常及排卵障碍三大核心表型，系统综述：(1) 各表型下丘脑–垂体–卵巢轴(HPO轴)、胰岛素抵抗(IR)及肾上腺源雄激素的异常模式；(2) 内分泌交互作用对卵泡发育障碍、代谢并发症的驱动机制；(3) 基于表型的内分泌靶向治疗策略(如抗雄药物、胰岛素增敏剂、中西医协同干预)。旨在为PCOS的精准分型诊疗提供理论依据。Polycystic ovary syndrome (PCOS), a highly heterogeneous gynecological endocrine disorder, exhibits significant differences in endocrine disturbance characteristics among its different phenotypes (Rotterdam classifications A/B/C/D). These differences directly influence disease progression and treatment outcomes. This article focuses on three core phenotypes—hyperandrogenism, metabolic abnormalities, and ovulatory dysfunction—and systematically reviews: (1) The abnormal patterns of the hypothalamic-pituitary-ovarian axis (HPO axis), insulin resistance (IR), and adrenal-derived androgens in each phenotype; (2) The driving mechanisms by which endocrine interactions impact follicular developmental disorders and metabolic complications; (3) Phenotype-based endocrine-targeted therapeutic strategies (such as anti-androgen drugs, insulin sensitizers, and integrated traditional Chinese and Western medicine interventions). The aim is to provide a theoretical basis for precision typing diagnosis and treatment of PCOS.