title: Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features.
abstract: BACKGROUND
  The Rotterdam criteria for polycystic ovary syndrome (PCOS) defines discrete subgroups whose phenotypes are not yet clear.
  
  
  OBJECTIVE
  The phenotypic characteristics of women in the PCOS subgroups defined by the Rotterdam criteria were compared.
  
  
  METHODS
  The study was observational.
  
  
  METHODS
  Subjects were studied in an outpatient setting in Boston and Reykjavik.
  
  
  METHODS
  Four subgroups of subjects with PCOS defined by 1) irregular menses (IM), hyperandrogenism (HA), and polycystic ovary morphology (PCOM, n = 298); 2) IM/HA (n = 7); 3) HA/PCOM (n = 77); and 4) IM/PCOM (n = 36) and a group of controls (n = 64), aged 18-45 yr, were examined.
  
  
  METHODS
  Subjects underwent a physical exam; fasting blood samples for androgens, gonadotropins, and metabolic parameters; and a transvaginal ultrasound.
  
  
  METHODS
  The phenotype was compared between groups.
  
  
  RESULTS
  Ninety-seven percent of women with IM/HA had PCOM. Therefore, the groups with and without PCOM were combined. The Ferriman-Gallwey score and androgen levels were highest in the hyperandrogenic groups (IM/HA and HA/PCOM), whereas ovarian volume was higher in all PCOS subgroups compared with controls, as expected based on the definitions of the PCOS subgroups. Body mass index and insulin levels were highest in the IM/HA subgroup.
  
  
  CONCLUSIONS
  Subjects with PCOS defined by IM/HA are the most severely affected women on the basis of androgen levels, ovarian volumes, and insulin levels. Their higher body mass index partially accounts for the increased insulin levels, suggesting that weight gain exacerbates the symptoms of PCOS.
authors.affiliation: Reproductive Endocrine Unit, BHX 511, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114, USA. cwelt@partners.org
authors.forename: C K
authors.initials: CK
authors.lastname: Welt
authors.forename: J A
authors.initials: JA
authors.lastname: Gudmundsson
authors.forename: G
authors.initials: G
authors.lastname: Arason
authors.forename: J
authors.initials: J
authors.lastname: Adams
authors.forename: H
authors.initials: H
authors.lastname: Palsdottir
authors.forename: G
authors.initials: G
authors.lastname: Gudlaugsdottir
authors.forename: G
authors.initials: G
authors.lastname: Ingadottir
authors.forename: W F
authors.initials: WF
authors.lastname: Crowley
mesh_terms: D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D005260:Female; D006062:Gonadotropins / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology; D008660:Metabolism / Q000502:physiology*; D008875:Middle Aged; D010641:Phenotype; D010808:Physical Examination; D011085:Polycystic Ovary Syndrome / Q000145:classification*
chemical_list: D000728:Androgens; D006062:Gonadotropins; D006728:Hormones