title: Characteristics of different phenotypes of polycystic ovary syndrome in a Bulgarian population.
abstract: OBJECTIVE
  Our aim was to investigate the percentage occurrence of different phenotypes of polycystic ovary syndrome (PCOS) in a Bulgarian population, and their clinical, biochemical and hormonal characteristics.
  
  
  METHODS
  The study included 70 women with PCOS, diagnosed according to the European Society of Human Reproduction & Embryology/American Society for Reproductive Medicine criteria. The women were divided into four phenotypes: hyperandrogenism (HA) + oligo-/anovulation (OA) + polycystic ovaries at ultrasound (PCO) (full-blown syndrome, phenotype A); HA + OA (former National Institutes of Health definition, phenotype B); OA + PCO (phenotype C); and HA + PCO (phenotype D). Serum levels of testosterone, immune-reactive insulin, sex hormone-binding globulin, dehydroepiandrosterone sulfate and lipid metabolism parameters were measured. Free androgen index and homeostasis model assessment of insulin resistance were calculated. Body mass index and waist-to-hip ratio were assessed.
  
  
  RESULTS
  The percentages of phenotypes A, B, C and D in a Bulgarian population are 58.6%, 11.4%, 10.0% and 20.0%, respectively. The women with the classical form of PCOS (phenotypes A and B) were more obese, had more strongly expressed hyperandrogenemia, and were more insulin-resistant compared with the women of phenotypes C and D.
  
  
  CONCLUSIONS
  There is a significant difference in anthropometric, hormonal and metabolic indices between the classical form and the clinical variants of PCOS in the studied Bulgarian population.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University, Plovdiv, Bulgaria. blago_pehlivanov@yahoo.com
authors.forename: Blagovest
authors.initials: B
authors.lastname: Pehlivanov
authors.forename: Maria
authors.initials: M
authors.lastname: Orbetzova
mesh_terms: D000328:Adult; D000858:Anovulation / Q000453:epidemiology*; D015992:Body Mass Index; D002031:Bulgaria / Q000453:epidemiology; D005260:Female; D006628:Hirsutism / Q000453:epidemiology*; D006801:Humans; D017588:Hyperandrogenism / Q000453:epidemiology; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000453:epidemiology*; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000145:classification / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology; D015995:Prevalence