The natural history of PCOS: Clinical, biochemical, hormonal and ultrasound findings of 1508 women with the Syndrome

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 532-553-Hyperandrogenic Disorders
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-535
Sarantis Livadas*1, Anastasios Kollias1, Athanasios Karachalios2, Eleni A Kandaraki3, Ilias Katsikis4, Dimitrios Panidis5 and Evanthia Diamanti-Kandarakis6
1Unit of Endocrinology, Metabolism and Diabetes, Athens, Greece, 2Sotiria Hospital, Athens University Medical School, Athens, Greece, 3University of Athens Medical School, Athens, Greece, 4Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece, 5Aristotle Univ Thessaloniki, Thessaloniki, Greece, 6Medical School University of Athens, Athens, Greece
Introduction: PCOS represents a continuum and the spectrum of the disorder is an ever-changing situation. The existing concept is that during early years of PCOS diagnosis, hyperandrogenic signs and hyperandrogenemia dominate the syndrome, which is transiently transformed to a metabolic disorder characterized from dyslipidemia and insulin resistance. However, this opinion originated from studies evaluating small groups. Furthermore, with the advent of ultrasonographic criteria in PCOS diagnosis, this notion should be additionally explored under this prism.

Aim of the study: To evaluate clinical, biochemical, hormonal and ultrasound findings trough time, in a cross-sectional manner.

Subjects and Methods: Data from 1508 women with PCOS (Rotterdam criteria) were analyzed. The mean age of the group was 24,31±5,79 years (range 15-48) and the mean BMI 26,77±7,13kg/m2 (range 16-38). In all subjects BMI, Waist to hip ratio (WHR), Systolic, diastolic blood pressure, Ferriman–Gallwey score (FG), white blood cell count, glucose, lipids (HDL,LDL, Triglycerides, Cholseterol, oxLDL), insulin, liver function tests, gonadotropins (LH, FSH), androgens, SHBG ovarian volume and total follicle count were analyzed.

Results: In the total group age was positively correlated with BMI and WHR and negatively with FG-score, all androgens, LH/FSH ratio, HOMA-IR and follicle number. When data was classified according to age (criterion 25 years), it was found that younger subjects were more hirsute, hyparandrogenic and have greater follicle number, whereas older subjects were more obese with higher WHR and oxLDL levels (for all comparisons p<0,005).  When total group was stratified according to BMI (criterion 25Kg/m2), it was found that lean women were younger and displayed better clinical, metabolic, hormonal and ultrasound profile. However, when data where stratified according to age and BMI, it was found that in overweight/obese subjects older than 25 years, age was negatively correlated with BMI, WHR, LH/FSH, androgens, ovarian volume and follicle number and not with any metabolic parameter, but in lean patients of the same age group, age was also negatively correlated with glycemia, insulin, HOMA-IR.

In overweight/obese subjects younger than 25 years, age was negatively correlated with BMI, WHR, FG, all androgens, glycemia, insulin, HOMA-IR and follicle number, but in lean young patients age was negatively correlated only with glycemia, insulin, HOMA-IR.

Conclusions: From the above study it is shown that through time not only androgenic signs, hyperandrogenemia and ultrasound findings improve, but also insulin resistance. This improvement is clearer in lean women, suggesting that insulin resistance and glycemia may be an obesity epiphenomenon in PCOS.

Nothing to Disclose: SL, AK, AK, EAK, IK, DP, ED

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