Serum uric acid levels in patients with different phenotypes of polycystic ovary syndrome

Background & objectives Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive-aged women, frequently associated with insulin resistance, obesity, and increased cardiovascular risk. Serum uric acid, linked to oxidative stress and endothelial dysfunction, may contribute to the cardiometabolic complications of PCOS. Although hyperuricemia is common in PCOS, differences in serum uric acid among phenotypes remain unclear. This study compared serum uric acid across PCOS phenotypes, hypothesising that classic, obese phenotypes would exhibit higher levels due to synergistic metabolic and hormonal effects. Methods A total of 180 women with PCOS [phenotypes A(n=96), B (n=19), C (n=35), and D (n=30)] and 51 age-matched controls were included. PCOS was diagnosed according to the revised 2003 Rotterdam criteria, and phenotyping was based on the presence of hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology. Fasting serum uric acid levels were measured using the uricase method, and hyperuricemia was detected as ≥6.0 mg/dL. Analyses were performed using the Shapiro-Wilk test for normality, Levene's test for homogeneity, and appropriate parametric or non-parametric tests with Holm correction for multiple comparisons. Results Among 231 women evaluated, age distributions were similar between groups. Median body mass index (BMI) and waist circumference (WC) were higher in the PCOS cohort, most prominently in Phenotype A (both P