Subjects

This clinical study was approved by the Internal Review and Ethics Boards of Renji Hospital, which is affiliated with Shanghai Jiao Tong University. All of the participants signed informed consent to be included in the study. Both newly diagnosed patients with PCOS and healthy controls were enrolled in the clinics of Renji Hospital. The study subjects were divided into 4 groups: lean control (LC; BMI <24 kg/m²; n = 18), obese (OB; BMI ≥28 kg/m²; n = 16), obese PCOS (OP; BMI ≥28 kg/m²; n = 15), and lean PCOS (LP; BMI <24 kg/m²; n = 17), on the basis of the Chinese criteria for BMI categories (24). The diagnostic criteria for PCOS were based on the unified standards formulated by the Rotterdam International Conference in 2003. Patients with any 2 of the following 3 conditions were diagnosed with PCOS: (1) infrequent ovulation or anovulation; (2) hyperandrogenism or clinical manifestations of high blood androgen; (3) ultrasound findings of polycystic ovaries in 1 or 2 ovaries, or ≥12 follicles measuring 2 to 9 mm in diameter, and/or ovarian volume ≥10 mL. Exclusion criteria included congenital adrenal hyperplasia, androgen-secreting tumors, Cushing syndrome, thyroid dysfunction, hyperprolactinemia, and other diseases (25). Patients in the control groups exhibited normal menstruation, no clinical or biochemical signs of hyperandrogenism, normal ovaries as defined by B-mode ultrasonic examination, no family history of endocrine and metabolic diseases, and no family history of PCOS.