Assessment of Clinical Profile and Biochemical Parameters in Diverse Phenotypes of Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is a polygenic and multifactorial condition, considered as the most common endocrine problem of women in reproductive age. Insulin resistance, hyper-androgenism and obesity significantly influence the pathophysiological process of PCOS. This study was designed to estimate clinical and biochemical parameters in different phenotypes of PCOS. The cross sectional descriptive type of observational study was carried out at Mymensingh Medical College Hospital, Bangladesh from January 2018 to June 2019 among purposively selected 107 patients with PCOS. Data were analyzed by computer software, SPSS, version 22.0. Quantitative variables of this study were summarized using mean and standard deviation and qualitative variables were summarized by percentage. Biochemical parameters in different phenotypes were compared with t-test. Phenotype A was found in highest number (59.8%) followed by phenotype B (14.9%), phenotype D (14.0%) and phenotype C (11.2%). Biochemical hyper-androgenism was observed highest in phenotype A (57.8%) followed by phenotype B (36.4%) and phenotype C (6.1%). Biochemical or clinical hyper-androgenism was not observed among patients of phenotype D. Mean age of phenotype A, B, C and D were 22.92±6.36, 20.81±3.69, 24.82±5.96 and 21.94±4.12 years respectively. All the phenotypic subgroups were found higher in the high and middle class urban family. Body mass index (BMI), waist circumference and waist hip ratio were increased in all phenotypes but more in phenotype A and B. Blood pressure had no significant change. Phenotype A presented with oligo-menorrhea (50.47%), amenorrhea (7.48%) and menorrhagia (1.87%). Majority of phenotype B (13.08%) and D (12.15%) presented with oligo-menorrhea. All the phenotype C (11.2%) had normal menstrual cycle. Hirsutism was more in phenotype A and B. Phenotype A presented with more severe acne (19.6%), acanthosis nigricans (38.3%), weight gain (34.6%) and subfertility (18.7%) than others. Phenotype A and B had high serum total cholesterol and triglyceride but low serum HDL. Phenotypic division helps in better understanding the pathophysiology of PCOS, severity of the disease and also helps in predicting the adverse effects. Moreover, identifying various phenotypes have diagnostic implications and also assist in providing appropriate treatment and prognosticating the patients.