Differences in clinical characteristics and cardiovascular disease risk prediction among Chinese women with polycystic ovary syndrome phenotypes: a cross-sectional study

Background: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular disease (CVD) risk, but differences across phenotypes in Chinese women remain unclear. This study aimed to characterize clinical profiles of PCOS phenotypes, predict CVD risks, and evaluate associations between phenotypes and CVD risk. Methods: A total of 206 women with PCOS were included from an initial cohort of 211 and classified into four phenotypes according to Rotterdam criteria. Clinical data, laboratory results, and imaging measurements were collected. CVD risks were estimated using the China-PAR model. One-way ANOVA and the Kruskal-Wallis test were used for continuous variables, and Pearson's chi-square or Fisher's exact test for categorical variables. Firth logistic regression was employed to assess the association between PCOS phenotypes and CVD risk, and mediation analysis detected the indirect effects. Results: Among 206 patients with PCOS, 104 (50.5%), 36 (17.5%), 19 (9.2%) and 47 (22.8%) were classified as phenotype A, B, C and D. BMI, WC, SBP, and DBP were significantly higher in phenotypes A, B, and C than in D (P