Abstract: P-374

Comparison of Metabolic Abnormalities Among PCOS Phenotypes - a Hospital-Based Study.

Presenter: Hui Li


Abstract


OBJECTIVE: To estimate differences in metabolic abnormalities among different PCOS phenotypes, and to explore the main factors that affect the metabolic abnormalities of patients with first diagnosis of PCOS.
DESIGN: Hospital-based observational study. view more

OBJECTIVE: To estimate differences in metabolic abnormalities among different PCOS phenotypes, and to explore the main factors that affect the metabolic abnormalities of patients with first diagnosis of PCOS.
DESIGN: Hospital-based observational study.
MATERIALS AND METHODS: PCOS phenotypes were recorded according to the 2003 Rotterdam criteria, including the classical phenotype (PCO+HA+OD); the ovulation phenotype (PCO+HA); the non-PCO phenotype (HA+OD); and the non-HA phenotype (PCO+OD). The prevalence of metabolic abnormalities among different PCOS phenotypes, including DM, MS, pre-DM, IR and dyslipidemia were compared.
RESULTS: A total of 2436 adult women who were hospitalized in Sun Yat-Sen University affiliated hospital from Jan. 1998 to Aug. 2015 in GuangZhou, China were included in this study. There was no significant difference in the prevalence of metabolic abnormalities or the distribution characteristics of the metabolic abnormalities among these four PCOS phenotypes (P> 0.05). The patients with HA in PCOS had significantly increased obesity (P = 0.014) and pre-DM (P = 0.024) compared with non-HA group. There were significant differences in DM, IFG, IGT, pre-DM, MS, IR, dyslipidemia and central obesity in the PCOS women with obesity (BMI≥23kg / m2) comparing with those without obesity (P <0.001). PCOS patients were divided into four groups according with obesity and HA or not. Metabolic abnormalities was the worst in the group with obesity + HA, followed by obesity + non-HA group. The prevalence of glucose metabolic disorders in the group with non-obesity + HA was slightly elevated comparing with non-obesity + non-HA, however, the prevalence of hyperlipidemia and MS in the group with obesity + non-HA was slightly higher than that of the group with non-HA + non-obesity.
CONCLUSIONS: It is necessary to assess metabolic abnormalities comprehensively, regardless of the PCOS phenotypes under NIH advocacy. Obesity is the major adverse factor in PCOS patients with metabolic abnormalities. Obese PCOS patients require special attention to metabolic status, regardless of whether they have hyperandrogenism. Hyperandrogenism might worsen the abnormal glucose metabolism in PCOS patients, especially in obese PCOS patients. The effects of hyperandrogenism on lipid metabolism in PCOS patients are different between obesity and non-obesity, which worsen abnormal lipid metabolism and the prevalence of MS in obesity PCOS patients, but is a protective factor in non-obesity.

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