Somatotype, metabolic features, and psychological distress in women with polycystic ovary syndrome: a case–control study

PCOS is a heterogeneous endocrine–metabolic disorder often associated with psychological distress. Changes in somatotype exist in women with PCOS; however, detailed somatotype patterns and associations between somatotypes and various psychological, metabolic, and hormonal characteristics have not been studied sufficiently. This study aimed to assess somatotype components in women with PCOS compared to normal age-matched controls and the relationship between somatotype, psychological distress, and metabolic-hormonal parameters. This case–control study included 200 women aged 18–35 years, including 100 patients with PCOS (diagnosed using the Rotterdam criteria) and 100 age-matched controls. Anthropometric measurements, somatotype classification using the Heath–Carter method, psychological evaluation using the Depression Anxiety Stress Scales–21 (DASS-21), and biochemical profile and hormone analysis were performed in all participants. Intergroup differences were compared using Welch’s t-test. Correlation analyses were performed for the individual components of somatotype with psychological variables using Pearson’s correlation and multiple linear regression analyses. A descriptive penalized logistic regression model was used to test the discriminatory potential of a combination of anthropometric, somatotype, and psychological variables. Women with PCOS had significantly increased endomorphy (7.21 vs. 5.48) and mesomorphy (4.83 vs. 4.23), and decreased ectomorphy (2.02 vs. 2.78) compared to controls (all p < 0(.)001). The mean PSQI [depression, anxiety, and stress] scores were significantly higher in the PCOS group than in the control group, while fasting glucose, luteinizing hormone, and testosterone levels were significantly higher than those in the normal cohort (all P < 0.001). Endomorphy was significantly positively correlated with depression (r = 0.80), anxiety (r = 0.79), and stress (r = 0.75), and ectomorphy was negatively associated with depression (r = − 0.65) and stress (r = − 0.43). Endomorphy was an independent correlate of psychological distress in women with PCOS in multivariate analyses. The exploratory discrimination model exhibited good separation between the PCOS and control groups. The current novel findings reveal a specific somatotype profile characterized by higher endomorphy and mesomorphy and lower ectomorphy in women with PCOS. Endomorphy is associated with increased psychological distress and metabolic and hormonal disturbances. This study revealed the significant relationship between somatotype dimensions in PCOS, particularly endomorphy, and psychological symptoms. Further follow-up and multi-institutional studies are necessary to clarify the sequence and timing of these associations.