Early Clinical, Biochemical and Radiological Features in Obese and Non-Obese Young Women with Polycystic Ovarian Syndrome: A Comparative Study

Abstract

Polycystic ovarian syndrome (PCOS) is a heterogenous condition accounting for serious health complications. The present study was conducted to assess the early clinical, biochemical, and radiological features in obese, non-obese young women with PCOS as compared to non-PCOS women. The study was conducted on 120 young women (18–22 years) with 80 having features of PCOS [40 obese (BMI≥25 kg/m2) and 40 non-obese (BMI<25 kg/m2) PCOS] as cases and 40 without PCOS as controls in a rural tertiary care center of Northern India over one year (2017–2018). After enrolment of cases and control, the anthropometric measurements, early clinical symptoms, and biochemical and ultrasonographic features were compared between the groups. Statistical analysis was done using SPSS software version 22.0 (p-value<0.05). A significant difference in anthropometric measurements were observed between obese and non-obese PCOS cases. Clinical features like acne, acanthosis nigricans, and hirsutism were more prevalent in obese PCOS as compared to non-obese and controls. On ultrasound, PCOS cases had a significantly increased number of peripherally arranged ovarian follicles, and ovarian volume. The LH: FSH ratio was significantly higher in cases as compared to controls. The levels of serum LH (10.04±1.60 vs. 8.93±2.40 mIU/ml) and total testosterone (2.71±0.39 vs. 2.21±0.39 pg/ml) were higher in obese PCOS as compared to non-obese PCOS cases. In conclusion, clinical, biochemical, and radiological features can be used in the early diagnosis of PCOS. Obesity is an independent risk factor for PCOS and is associated with an increased risk of complications.

Polycystic Ovarian Syndrome (PCOS) among young adult women: an anthropological insight

“…On the contrary, Ray [113] has reported that obesity is positively associated with PCOS individuals in the rural population. Waist circumference and clinical indicators of hyperandrogenism should be taken into account while developing effective treatment plans [33,77,103].…”

Acanthosis Nigricans: Pointer of Endocrine Entities

“…Although it is still unknown whether IR is a cause or effect of PCOS, the strong connection between AN and PCOS is based on the mechanisms of IR and hyperinsulinemia, which could also explain elevated levels of free testosterone in the PCOS population. Although it is a well-known fact that AN is associated with obesity and IR, there are limited data regarding normal-weighted people with PCOS [ 126 , 127 , 128 , 129 , 130 , 131 , 132 ]. As expected, AN was more frequent among obese women with PCOS versus normal-weighted women with PCOS; however, obesity itself is recognized as an independent risk factor for IR, irrespective of PCOS [ 126 ].…”

“…Although it is a well-known fact that AN is associated with obesity and IR, there are limited data regarding normal-weighted people with PCOS [ 126 , 127 , 128 , 129 , 130 , 131 , 132 ]. As expected, AN was more frequent among obese women with PCOS versus normal-weighted women with PCOS; however, obesity itself is recognized as an independent risk factor for IR, irrespective of PCOS [ 126 ].…”

Simplify your approach to the diagnosis and treatment of PCOS

“…Secondary supporting laboratory findings consistent with PCOS include: 1) a markedly elevated anti-müllerian hormone (AMH) level, 12 2) an elevated fasting insulin level, 2,13 and 3) an elevated luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio. 13,14 But it is not necessary to measure AMH, fasting insulin, LH, and FSH levels. To conserve health care resources, I recommend against measuring those analytes to diagnose PCOS.…”