Background: Polycystic ovary syndrome is a common and heterogeneous endocrine disorder characterized by hirsutism, amenorrhea, infertility, and obesity. Our primary aim to conduct this study was to find out the correlation between various biochemical and clinical features of polycystic ovarian syndrome and to determine the best hormonal marker for the same among Indian women at an early age.

Materials & Methods: The study was done on outdoor patients over seventy women with PCOS diagnosed by history and hormonal levels (LH: FSH ratio>2, total testosterone>0.76 ng/mL) and ultrasonogrpahy (USG) (cortical cysts each 5 mm in diameter, >5 in number in a single ovary) were compared with 10 normal women who served as control at a tertiary care teaching hospital, Kolkata. Obesity was measured by body mass index (BMI) (>25 kg/m² taken as overweight). Waist: hip ratio (WHR) was used as a marker of abdominal obesity (measured at ASIS). Ferriman-Gallway (FG) scoring was done and a score of > 8 was taken as significant hirsutism.

Results: Hormonal status and BMI in PCOS individuals, who were overweight (BMI > 25 kg/m²). They had a mean BMI 28.98 kg/m², mean basal insulin (BI) 33.49 μ IU/ ml, mean LH: FSH ratio 2.01, mean testosterone level 1.38 ng/ml. Mean body mass index (BMI) was 21.6 kg/m² in normal women, 27.44 kg/m² in overweight subjects(n=44) and 31.86 kg/m² in obese subjects (n=21). When FG score>8 was considered, it was found that overweight subjects were 35.4% and obese 40%. Increased value of basal insulin was found in 14 subjects (40%). Family history of hirsutism was positive in 7 subjects (22.5%). In this group, mean BMI 29.24 kg/m^2, mean basal insulin 32.94 m-IU/ml, mean LH/FSH Ratio 1.96 and mean testosterone 1.96 ng/ml.

Conclusion: Most of the PCOS patients of this city are overweight rather than obese. In PCOS there was increased LH and there by increased LH-FSH ratio, which is usually used as a single hormonal estimation for diagnosis. In accordance to previous studies it may be suggestable that the free or total testosterone level can be a singular and vital hormonal marker for diagnosis. Both LH-FSH ratio and testosterone can be taken for accuracy of diagnosis.

Keywords: Polycystic ovarian syndrome, clinical, biochemical, ultrasonography, acanthosis nigricans, hirsutism.

1. Franks S. Polycystic ovary syndrome. N Engl J Med. 1995;333(13):853- 861.
2. Copp T, Jansen J, Doust J, Mol BW, Dokras A, McCaffery K. Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome? BMJ. 2017 Aug 16. 358:j3694.
3. Hackethal V. PCOS Diagnosis: One Size Does Not Fit All. Medscape News & Perspective. Available at http://www.medscape.com/viewarticle/884712#vp_1. Accessed: August 28, 2018.
4. Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol.2011 Aug;24(4):223-7.
5. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol.2004 Oct;18(5):671-83.
6. Azziz R, Carmina E, Dewailly D, et al. Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009 Feb. 91(2):456-88.
7. Lobo RA, Carmina E. Importance of Diagnosing PCOS. Annuals of Internal Medicine 2000; 32:989-993.
8. Ferriman D, Gallwey JD. Clinical assessment of body hair in women. J Clin Endocrinol Meta. 1961; 21:1440–7.
9. Buckett WM1, Bouzayen R, Watkin KL, Tulandi T, Tan SL. Ovarian stromal echogenicity in women with normal and polycystic ovaries. Hum Reprod. 1999 Mar;14(3):618-21.
10. Nazir, S. Sayeed, M. Malik, H. Aziz and S. A. S. Rana, “Polycystic Ovarian Syndrome—Diagnosis and Management in Fertility Deprivation,” Pakistan Journal of Obstetrics & Gynecology, Vol. 12, No. 1-2, 1999, pp. 59-71.
11. Nasr AA, Hamzah H, El Maaty ZA, Gaber H, Azzam O. Transvaginal Appearances of Ovary in Infertile Women with Oligomenorrhae: Association with Clinical & Endocrine Profile. Middle East Fertility Society Journal 2004; 9(2):140-149.
12. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):671-83.
13. Duignan NM, Shaw RW, Rudd BT, et al. Sex hormone levels and gonadotrophin release in the PCOS. Clin Endocrinol (Oxf) 1975; 4:287-95.
14. Zargar AH, Wani AI, Masoodi SR, et al. Epidemiologic and etiologic aspects of hirsutism in Kashmiri women in Indian subcontinent. Fertil Steril 2002; 77: 674-78.
15. Hassa H, Tanvir HM,  Yildiz Z. Comparison of Clinical and Laboratory Characteristic of Cases with Polycystic Ovarian Syndrome Based on Rotterdam Criteria and Women with Only Clinical Signs Are Oligo/Anovolution or Hirsutism. Archives of Gynecology and Obstetrics 2006; 274(4):227-232.
16. Razak A, Nadak A, Tace A. Polycystic Ovarian Syndrome: The Correlation between the LH: FSH and Disease Manifestations. Middle East Fertility Society Journal 2007; 12(1):35-40.
17. Asuncion M, Calvo RM, San Milan JL, et al. A prospective study of the prevalence of the PCOS in unselected caucasian women from Spain. J Clin Endocrinol Metabol 2000; 85: 2434-8.
18. Khan MI, Klachko DM. Polycystic ovarian syndrome. e-Medicine Journal online, updated in 2002.
19. Pache TD, Fauser BCJM. Arrest of follicular maturation in the polycystic ovary syndrome: endocrine and sonographic aspects. Exp Clin Endocrinol (Life Sci Adv) 1991;10:1-6.
20. Nazir F, Sayeed S, Malik M, Aziz H, Rana SAS. Polycystic Ovarian Syndrome—Diagnosis and Management in Fertility Deprivation. Pakistan Journal of Obstetrics & Gynecology 1999; 12(1-2):59-71.
21. Razak A, Nadak A, Tace A. Polycystic Ovarian Syndrome: The Correlation between the LH:FSH and Disease Manifestations. Middle East Fertility Society Journal 2007; 12(1):35-40.
22. Yousouf R, Khan M, Kounsar Z, Ahangar S, Lone WA. Polycystic Ovarian Syndrome: Clinical Correlation with Biochemical Status. Surgical Science 2012; 3: 245-248.

Dr Paramita Pal

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Contact No.:8240037958