ArticleJournal of the Turkish German Gynecological Association2026
Comparative analysis of hormonal and metabolic indices in phenotypic subgroups of polycystic ovary syndrome.
Article in Journal of the Turkish German Gynecological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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