Clinical and laboratory indicators of polycystic ovary syndrome in Chinese Han nationality with different Rotterdam criteria-based phenotypes

Abstract

The aim of this study was to investigate the clinical, endocrinic and metabolic indicators in polycystic ovary syndrome (PCOS) with different Rotterdam criteria (RC)-based subtypes, thus to guide the treatments. Six hundred and forty-seven PCOS cases were divided into four groups, with 60 cases set as the control group, the clinical and endocrinic indicators of different subtypes were evaluated. Group A was the most common and the most serious (63.2%), while group B was the least (9%). The clinical signs, as well as the endocrinic and metabolic characteristics, of the two groups were similar, but group A exhibited higher androgen level and hirsutism score. The phenotypes of group C (15.6%) and group D (12.9%) were mild, but compared with the control group, luteinizing hormone (LH) and LH/follicle stimulating hormone (FSH) were significantly increased. Insulin resistance in these four subtypes were positively correlated with apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1), while only positively correlated with serum total testosterone, and negatively correlated with LH/FSH in group A. RC-PCOS typing could reflect the basic characteristics of the disease. Hyperandrogenism was the main basis for distinguishing PCOS, although the non-hyperandrogenism group could represent a relatively mild phenotype of PCOS, there might exist different pathogenic pathways.

Chinese abstract

这项研究的目的是为了研究按照鹿特丹诊断标准分类的多囊卵巢综合征（PCOS）的不同表型的临床特点，内分泌及代谢指标，以指导临床治疗。研究中，647名PCOS的患者按照鹿特丹标准被分为四组，另设60例作为对照组，对各组的临床指标和各项代谢指标进行评估。组A满足PCOS的三条标准，为月经稀发或无排卵、高雄激素和多囊卵巢，为最常见也是最严重的，占63.2%，组B为月经稀发或无排卵和高雄激素，该组数量最少占9%，从临床特点以及内分泌和代谢的指标来看，这两组是相似的，但是组A的雄激素水平和痤疮的评分更高。组C为高雄激素和多囊卵巢（15.6%）和组D为月经稀发或无排卵和多囊卵巢（12.9%）是轻度的，但是和对照组相比，其促黄体生成素（LH）和促黄体生成素与卵泡刺激素（FSH）的比值都有轻微的升高。四组研究组中胰岛素抵抗都和载脂蛋白B与载脂蛋白A1（ApoB/ApoA1）的比值成正相关，但是在组A中与血清总雄激素水平正相关，与LH/FSH呈负相关。PCOS的鹿特丹标准的分型，能够反映疾病基本的临床特点。高雄激素血症是PCOS主要的诊断依据，但是没有高雄激素血症的PCOS是病情相对较轻的PCOS亚型，可能存在不同的发病机制。

• Insulin resistance
• phenotype
• polycystic ovary syndrome
• rotterdam criteria
• testosterone

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Corrigendum

Declaration of interest

This study was supported by Beijing Municipality Health Technology High-level Talent (2014-2-016), Project of Discipline Leader, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital (2013-1), Foreign technical and administrative talent introduction project in 2015, State Administration of Foreign Experts Affairs, China (GDJ20151100013).

All of the authors declare that they have no conflicts of interest regarding this paper.