“PHENOTYPIC VARIATION IN POLYCYSTIC OVARY SYNDROME: A CROSS-SECTIONAL STUDY OF METABOLIC AND REPRODUCTIVE SUBTYPES IN A TERTIARY CARE HOSPITAL OF TRIPURA”.

Abstract

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder characterized by distinct reproductive and metabolic phenotypes, each with unique clinical and biochemical profiles. Data on PCOS phenotypes from Tripura, a northeastern Indian state with unique demographic and lifestyle characteristics, remain limited. Methods: A cross-sectional study was conducted over 21 months at a tertiary care hospital in Tripura, including 75 women with PCOS diagnosed using the Rotterdam criteria (2003) and 60 healthy controls. Participants underwent anthropometric, hematological, and biochemical assessments. PCOS cases were categorized into reproductive, metabolic, and intermediate phenotypes based on hormonal and metabolic parameters. Statistical analysis included ANOVA, chi-square test, and Spearman’s correlation, with p < 0.05 considered significant. Results: Among PCOS patients, 48% were metabolic, 38.7% intermediate, and 13.3% reproductive phenotype. The metabolic phenotype showed significantly higher weight, BMI, body fat, visceral fat, triglycerides, cholesterol, and insulin levels (p < 0.05), indicating increased metabolic risk. The reproductive phenotype exhibited elevated luteinizing hormone and sex hormone-binding globulin, reduced progesterone, and significantly lower hemoglobin and RBC counts (p < 0.05), suggesting possible hematological vulnerability. Estradiol levels were highest in the metabolic group. The reproductive phenotype was more common in younger women (19–21 years), while the metabolic phenotype predominated in slightly older individuals (22–24 years). Conclusion: PCOS phenotypes demonstrate distinct clinical and biochemical profiles. These findings support phenotype-specific management strategies, emphasizing metabolic risk reduction in metabolic PCOS and targeted reproductive and hematological care in reproductive PCOS.