Obesity-Driven Variations in Endocrine Profiles among Polycystic Ovarian Syndrome Phenotypes in A Cross-Sectional Epidemiologic Study: Obesity and Metabolic Variations in PCOS

Background: The management approaches for polycystic ovary syndrome (PCOS) vary between lean and overweight patients which led to this research investigating clinical and endocrine differences among lean and obese/ overweight PCOS individuals. Objective was to evaluate the clinical and hormonal differences between obese/ overweight and lean phenotypes of women with PCOS. Methods and Materials: The study executed between January 2021 and March 2022 at B M Patil Medical College and Hospital in Vijayapur, included 77 women aged 21-35 who met the Rotterdam criteria for PCOS diagnosis. Participants were dichotomized as lean (≤23 kg/m²) or obese/ overweight (>23 kg/m²), with the sociodemographic information collected as well as clinical assessments and hormone measurements. Results: The 77 participants comprised 33 lean and 44 obese/ overweight individuals. Lean women experienced more irregular menstrual cycles, while obese/overweight women had higher rates of dysmenorrhea. Waist-hip ratios differed significantly, with 60.6% of lean women having a ratio ≤0.8 and 86.4% of obese/ overweight women exceeding 0.8. Hirsutism and acne were more prevalent in obese/ overweight individuals, with statistical significance. Lean women had higher proportion of elevated free testosterone levels (>6.3pg/mL) at 39% compared to 22.7% of obese/overweight women had a higher proportion. Obese/ overweight women had a higher proportion of LH: FSH ratios ≥1(59.1%) compared to lean participants (45.5%). Conclusion: The findings highlight the clinical and hormonal disparities between lean and obese/overweight PCOS patients, underscoring the importance of BMI in PCOS management. Limitations include the small size and lack of multivariate analysis, which may affect generalizability and control for confounding variables.