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首页> 外文期刊>Indian Journal of Endocrinology and Metabolism >Comparison of the different PCOS phenotypes based on clinical metabolic, and hormonal profile, and their response to clomiphene
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Comparison of the different PCOS phenotypes based on clinical metabolic, and hormonal profile, and their response to clomiphene

机译：根据临床代谢和激素状况比较不同PCOS表型及其对克罗米芬的反应

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Objective: To compare the different polycystic ovarian syndrome (PCOS) phenotypes based on their clinical, metabolic, hormonal profile, and their differential response to clomiphene. Design: Prospective observational study. Setting: Infertility clinic, a government hospital. Sample Size: 164 women with PCOS-related infertility. Materials and Methods: Sample population was divided into four phenotypes based on the NIH (National Institute of Health) consensus panel criteria. The incremental dose of clomiphene from 50 to 150 mg/day over three cycles was given. Outcome Measures: Clinical history, metabolic, hormonal profile, and ultrasound features of each phenotype. Also, the response to clomiphene citrate was studied as presence or absence of ovulation. Results: The prevalence of phenotypes A, B, C, and D were 67.7%, 11%, 17.7%, and 3.6%, respectively. Phenotype A had significantly higher weight, body mass index, clinical, and biochemical hyperandrogenism, menstrual irregularities, ovarian reserve parameters, fasting insulin, HOMA-IR, and more deranged lipid profile (P 0.05). Clomiphene resistance was significantly more common in phenotype A (P 0.05). No significant differences were noted in the waist circumference, waist-hip ratio, blood pressure and blood sugar values (fasting, 1-hour postprandial, 2-hour postprandial). Also, the Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), LH-FSH ratio, 17-hydroxyprogesterone, and vitamin D levels were not significantly different among various PCOS phenotypes. Conclusion: Full-blown PCOS (phenotype A) is at a higher risk of adverse metabolic and cardiovascular outcomes as compared with the others, and phenotype D is the least severe phenotype. Thus, the phenotypic division of patients with PCOS-related infertility can help in prognosticating the patients about the severity of the disease and the fertility outcome.
机译：目的：根据临床，代谢，激素水平及其对克罗米芬的差异反应，比较不同的多囊卵巢综合症（PCOS）表型。设计：前瞻性观察研究。地点：不孕诊所，政府医院。样本量：164名患有PCOS相关性不育的女性。材料和方法：根据NIH（美国国立卫生研究院）共识专家组标准，将样本人群分为四种表型。给予了克罗米芬在三个周期内从50到150毫克/天的增量剂量。结果测量：每种表型的临床病史，代谢，激素水平和超声特征。另外，研究了对柠檬酸克罗米酚的反应是有无排卵。结果：表型A，B，C和D的患病率分别为67.7％，11％，17.7％和3.6％。表型A具有明显更高的体重，体重指数，临床和生化高雄激素血症，月经不规则，卵巢储备参数，空腹胰岛素，HOMA-IR和更紊乱的脂质分布（P <0.05）。克罗米芬耐药性在表型A中更为常见（P <0.05）。腰围，腰臀比，血压和血糖值（空腹，餐后1小时，餐后2小时）没有显着差异。另外，各种PCOS表型之间的促卵泡激素（FSH），促黄体激素（LH），LH-FSH比，17-羟基孕酮和维生素D水平也没有显着差异。结论：成熟的PCOS（表型A）与其他相比具有较高的不良代谢和心血管结局风险，表型D是最不严重的表型。因此，与PCOS相关的不育症患者的表型划分可以帮助预后疾病的严重程度和生育结果。

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