title: Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome.
abstract: OBJECTIVE
  Current diagnostic criteria for polycystic ovary syndrome (PCOS) have generated distinct PCOS phenotypes, based on the different combinations of diagnostic features found in each patient. Our aim was to assess whether either each single diagnostic feature or their combinations into the PCOS phenotypes may predict insulin resistance in these women.
  
  
  METHODS
  A total of 137 consecutive Caucasian women with PCOS, diagnosed by the Rotterdam criteria, underwent accurate assessment of diagnostic and metabolic features. Insulin sensitivity was measured by the glucose clamp technique.
  
  
  RESULTS
  Among women with PCOS, 84.7% had hyperandrogenism, 84.7% had chronic oligoanovulation, and 89% had polycystic ovaries. According to the individual combinations of these features, 69.4% of women had the classic phenotype, 15.3% had the ovulatory phenotype, and 15.3% had the normoandrogenic phenotype. Most subjects (71.4%) were insulin resistant. However, insulin resistance frequency differed among phenotypes, being 80.4%, 65.0%, and 38.1%, respectively, in the 3 subgroups (P < .001). Although none of the PCOS diagnostic features per se was associated with the impairment in insulin action, after adjustment for covariates, the classic phenotype and, to a lesser extent, the ovulatory phenotype were independently associated with insulin resistance, whereas the normoandrogenic phenotype was not. Metabolic syndrome frequency was also different among phenotypes (P = .030).
  
  
  CONCLUSIONS
  There is a scale of metabolic risk among women with PCOS. Although no single diagnostic features of PCOS are independently associated with insulin resistance, their combinations, which define PCOS phenotypes, may allow physicians to establish which women should undergo metabolic screening. In metabolic terms, women belonging to the normoandrogenic phenotype behave as a separate group.
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Piazzale Stefani, Verona, Italy. paolo.moghetti@univr.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Moghetti
authors.forename: Flavia
authors.initials: F
authors.lastname: Tosi
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bonin
authors.forename: Daniela
authors.initials: D
authors.lastname: Di Sarra
authors.forename: Tom
authors.initials: T
authors.lastname: Fiers
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Kaufman
authors.forename: Vito Angelo
authors.initials: VA
authors.lastname: Giagulli
authors.forename: Chiara
authors.initials: C
authors.lastname: Signori
authors.forename: Francesca
authors.initials: F
authors.lastname: Zambotti
authors.forename: Marlene
authors.initials: M
authors.lastname: Dall'Alda
authors.forename: Giovanna
authors.initials: G
authors.lastname: Spiazzi
authors.forename: Maria Elisabetta
authors.initials: ME
authors.lastname: Zanolin
authors.forename: Enzo
authors.initials: E
authors.lastname: Bonora
mesh_terms: D000328:Adult; D000858:Anovulation / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D007206:Individuality; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000145:classification* / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone