Polycystic ovary syndrome (PCOS) has a heterogeneous phenotypic distribution that can potentially lead to variations in metabolic repercussions. A cross-sectional study was conducted with 372 women of reproductive age (146 of whom were ovulatory and 226 with PCOS) divided into groups according to PCOS phenotype: (i) complete phenotype involving menstrual irregularity (MI), hyperandrogenism (H), and ultrasound (US) findings of polycystic ovaries (132 patients); (ii) MI + H (18 patients); (iii) MI + US (51 patients); and (iv) H + US (25 patients). The frequencies of metabolic syndrome (MetS) were 45.4%, 38.9%, 33.3%, 36%, and 8.2% for the MI + H + US, MI + H, MI + US, H + US, and control groups (P < .01), respectively. In logistic regression, body mass index ([BMI] odds ratio [OR]: 1.1, 95% confidence interval [CI] 1.1-1.2) and the association of the complete phenotype with MI + H (OR: 5.8 CI95% [2.2-15.8) were independent predictors of the occurrence of MetS. The defining characteristics of MetS were more frequently found in women with PCOS than in controls, regardless of the phenotype (P < .01 for each variable). In conclusion, the frequency of MetS is similar for various PCOS phenotypes among young Brazilian women from the Southeast region of the country, although only BMI and the presence of MI + H, regardless of the presence of US findings, were more predictive of the development of MetS.
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