Assessment of metabolic risk among the Rotterdam's polycystic ovary syndrome phenotypes in Bangalore

Background: Polycystic Ovary Syndrome (PCOS) is characterized by a variety of complex manifestations with an unclear underlying cause. This condition is consistently linked to an increased cardio-metabolic risk. It is essential to evaluate this risk at the phenotype level to identify the most vulnerable subgroup within the PCOS population. Aim and Objectives: To phenotype the PCOS patients as per the standard Rotterdam's criteria and to assess the metabolic syndrome markers in those phenotypes. Material and Methods: A total of seven hundred participants (n=700) were assessed and categorized based on the Rotterdam criteria. Clinical, radiological, and biochemical assessments were conducted and analyzed statistically. Chi-square and two-way ANOVA tests were conducted using SPSS version 19 statistical software. The results indicated that phenotype A was the most prevalent, comprising 83.2% (583) of the cases, followed by phenotype C at 8% (56), phenotype D at 5.55% (39), and phenotype B at 3.1% (22). Notably, phenotype B, while being the least prevalent, exhibited the highest metabolic risk. This phenotype was significantly associated with increased levels of hirsutism, postprandial hyperinsulinemia, impaired glucose tolerance, and hormonal imbalances. Additionally, although not statistically significant, there was a higher occurrence of family history of metabolic syndrome, elevated waist circumference (greater than 35 inches), obesity, stress, and dyslipidemia associated with this phenotype. Conclusion: The highest metabolic risk was observed in phenotype B, which was characterized by a combination of hyperandrogenism and irregular menstruation in the absence of polycystic ovaries.