Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-age women. Important factors in its pathogenesis are hyperinsulinaemia and insulin resistance, which lead to higher risk of metabolic syndrome (MetS) and its complications. With the implementation of the Rotterdam diagnostic criteria in 2003, the group of PCOS patients became highly heterogeneous, with varying metabolic risk reported for different phenotypes of the syndrome. The aim of the present review is to assess the prevalence and severity of MetS and its components in patients with the four phenotypes of PCOS. A comprehensive search of Pubmed database was performed to identify studies comparing metabolic characteristics between PCOS patients with different phenotypes of the syndrome. The results of 60 studies published between 2004 and 2020 were retrieved and analysed. More adverse metabolic profile was observed in PCOS patients with hyperandrogenic phenotypes in comparison to normoandrogenic patients, as well as in classic phenotypes, defined by National Institutes of Health criteria, in comparison to newer phenotypes introduced by the Rotterdam criteria. In the majority of observations, normoandrogenic PCOS patients did not differ significantly from controls in terms of metabolic characteristics, although some East Asian studies reported more adverse metabolic profile in normoandrogenic phenotype in comparison to healthy women. In conclusion, metabolic abnormalities in PCOS seem to be associated with joint effects of hyperandrogenism, insulin resistance and visceral obesity. The differences observed between the four phenotypes of PCOS underline the need for individualised diagnostic and therapeutic approach.

中文翻译：

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多囊卵巢综合征不同表型的代谢综合征及其成分

多囊卵巢综合征 (PCOS) 是影响育龄妇女的最常见内分泌疾病。其发病机制中的重要因素是高胰岛素血症和胰岛素抵抗，这导致代谢综合征 (MetS) 及其并发症的风险更高。随着 2003 年鹿特丹诊断标准的实施，PCOS 患者群体变得高度异质，据报道该综合征的不同表型具有不同的代谢风险。本综述的目的是评估 MetS 及其成分在 PCOS 四种表型患者中的患病率和严重程度。对 Pubmed 数据库进行了全面搜索，以确定比较具有不同综合征表型的 PCOS 患者之间代谢特征的研究。检索和分析了 2004 年至 2020 年间发表的 60 项研究的结果。与正常雄激素患者相比，在具有高雄激素表型的 PCOS 患者中观察到更不利的代谢特征，以及在美国国立卫生研究院标准定义的经典表型中，与鹿特丹标准引入的新表型相比。在大多数观察中，雄激素正常的 PCOS 患者在代谢特征方面与对照组没有显着差异，尽管一些东亚研究报告与健康女性相比，正常雄激素表型的代谢特征更为不利。总之，PCOS 的代谢异常似乎与高雄激素血症、胰岛素抵抗和内脏肥胖的联合作用有关。