Comparative analysis of hormonal and metabolic indices in phenotypic subgroups of polycystic ovary syndrome


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Savran Üçok B., Dikici Aktaş T., Özalp E., Ulusoy C. O., Akbulut Ö. V., Kından A., ...Daha Fazla

Journal of the Turkish German Gynecology Association, cilt.27, sa.1, ss.29-35, 2026 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/jtgga.galenos.2026.2025-9-22
  • Dergi Adı: Journal of the Turkish German Gynecology Association
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Sayfa Sayıları: ss.29-35
  • Anahtar Kelimeler: Polycystic ovary syndrome, Rotterdam phenotypes, insulin resistance, TyG index, free androgen index, hirsutism, LH/FSH, AMH
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: To compare hormonal and metabolic characteristics across Rotterdam polycystic ovary syndrome (PCOS) phenotypes (A-D) and identify key predictors of hyperandrogenism. Material and Methods: In this retrospective cohort study, women with PCOS were classified into four Rotterdam phenotypes. Hormonal and metabolic parameters were assessed in the early follicular phase, and composite indices including HOMA-IR, QUICKI, TG/HDL, and free androgen index (FAI) were calculated. Logistic regression and receiver operating characteristic analysis were used to evaluate predictors of hirsutism. Results: The study included 226 women, with respective phenotype subgroups of: A n=85; B n=29; C n=43; and D n=69. Phenotype A showed the most pronounced hyperandrogenic and metabolic alterations, whereas phenotype D displayed the mildest profile with lower androgen levels and hirsutism scores. Significant differences in insulin resistance and lipid-related indices were observed across phenotypes. FAI was the strongest predictor of hirsutism (area under the curve =0.861), followed by total testosterone and dehydroepiandrosterone sulfate, while sex-hormone binding globulin was inversely associated. Conclusion: PCOS phenotypes demonstrate distinct hormonal and metabolic patterns. Phenotype A represents the most metabolically and androgenically severe subgroup, whereas phenotype D is comparatively mild. FAI emerges as the most informative marker for hirsutism, supporting a phenotype-oriented approach to clinical assessment and follow-up in PCOS.