Comparison of Endocrine and Metabolic Profile of Obese and Lean PCOS Women with Infertility

ReseaRch aRticlecauses of HA, primary hypothalamic amenorrhea, primary ovarian failure, thyroid disease, and prolactin disorder were excluded.The study was ethically conducted in accordance with the Declaration of Helsinki.Ethical approval was obtained prior to the commencement of the study (90th ECM/II B-Thesis/P36).The women enrolled underwent an assessment of height, weight, and BMI.Women were classified into two groups according to BMI group I with BMI <23 kg/m 2 (lean and underweight) and group II with BMI ≥23 kg/m 2 (obese and overweight) according to ICMR guidelines.A detailed menstrual history pattern was taken, and cycles at >35 days interval were classified as oligomenorrhea.These women were compared with reference to waist hip ratio (WHR).Circumference of the waist was measured at the level of the iliac crest after a normal expiration, and hip circumference was taken at the widest point around the buttocks.Abnormal WHC was taken as ≥0.8.Signs of clinical HA like acne, hirsutism, and AN were IntroductIonThe PCOS is the commonest endocrine disorder in reproductive-aged women, with a prevalence of 6-10%. 1 It is a leading cause of infertility and is also associated with an increased risk of metabolic syndrome, diabetes mellitus type II, cardiovascular disease, and endometrial cancer.PCOS affects 30% of infertile women. 1 A majority (60%) of women with PCOS have an above-average or high BMI, insulin resistance (IR), menstrual symptoms, and the typical male pattern of baldness, acne, and hirsutism.Although PCOS is commonly associated with obesity, a lean phenotype also exists.There are different phenotypes of PCOS depending on hyperandrogenism (HA), anovulation, and polycystic morphology on ultrasound.In addition, the pathology of PCOS is related to IR and hyperinsulinemia.Previous studies in India by Majumdar and Singh 2 have shown that IR, acne, and hirsutism are more often seen in obese PCOS and women with hyperandrogenic phenotypes.Lean women with PCOS, on the other hand, have different phenotypic, metabolic, hematologic, and neurologic characteristics than obese participants with PCOS.Therefore, it is hypothesized that obese and lean PCOS women may have different morphology, metabolic, and endocrine characteristics, although they have similar dysfunction.Hence, it is imperative to understand the difference between the two subgroups to plan an appropriate management approach.