Observation of phenotypic variation among Indian women with polycystic ovary syndrome (PCOS) from Delhi and Srinagar

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder that demonstrates ethnic and regional differences. To assess the phenotypic variability among Indian PCOS women, we evaluated clinical, biochemical and hormonal parameters of these women being followed in two tertiary care institutions located in Delhi and Srinagar. A total of 299 (210 PCOS diagnosed by Rotterdam 2003 criteria and 89 healthy) women underwent estimation of T4, TSH, LH, FSH, total testosterone, prolactin, cortisol, 17OHP, and lipid profile, in addition to post OGTT, C-peptide, insulin, and glucose measurements. Among women with PCOS, mean age, age of menarche, height, systolic, diastolic blood pressure, and serum LH were comparable. PCOS women from Delhi had significantly higher BMI (26.995.38 versus 24.77 +/- 4.32kg/m(2); P=0.01), glucose intolerance (36 versus 10%), insulin resistance as measured by HOMA-IR (4.20 +/- 3.39 versus 3.01 +/- 2.6; P=0.006) and QUICKI (0.140 +/- 0.013 versus 0.147 +/- 0.015; P=0.03) while PCOS from Srinagar had higher FG score (12.12 +/- 3.91 versus 10.32 +/- 2.22; P=0.01) and serum total testosterone levels (0.65 +/- 0.69 versus 0.86 +/- 0.41ng/ml; P=0.01. Two clear phenotypes, i.e. obese hyperinsulinaemic dysglycemic women from Delhi and lean hyperandrogenic women from Srinagar are emerging. This is the first report on North Indian women with PCOS showing phenotypic differences in clinical, biochemical and hormonal parameters despite being in the same region.