{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T12:30:25Z","timestamp":1787574625949,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objective: Polycystic ovary syndrome (PCOS) and nonclassic congenital adrenal hyperplasia (NCAH) overlap clinically, but direct comparative data specifically addressing non-National Institutes of Health (non-NIH) Rotterdam phenotypes of polycystic ovary syndrome are limited. We compared women with polycystic ovary syndrome, of whom 66.7% were classified as having non-NIH Rotterdam phenotypes, with women with nonclassic congenital adrenal hyperplasia and healthy controls to characterize the extent of phenotypic overlap and evaluate the discriminatory performance of individual androgen measures. Methods: This single-center, prospective, exploratory cross-sectional study evaluated 58 women divided into three groups: PCOS (n = 24, Rotterdam criteria), NCAH due to 21-hydroxylase deficiency (n = 16, previously confirmed by adrenocorticotropic hormone (ACTH)-stimulated 17-hydroxyprogesterone (17-OHP)), and healthy controls (n = 18). Demographic, clinical, metabolic, and hormonal parameters were compared using analysis of variance (ANOVA), Kruskal\u2013Wallis with Dunn\u2019s post hoc test (Bonferroni-adjusted), and chi-square or Fisher\u2019s exact tests. A sensitivity analysis was performed after excluding 12 participants receiving oral contraceptives (n = 8) or glucocorticoids (n = 4). Results: Within the PCOS group, 66.7% had non-NIH Rotterdam phenotypes. Hirsutism, defined as a modified Ferriman\u2013Gallwey (mFG) score \u2265 8, was more frequent in both patient groups than in controls (p = 0.003) but did not differ between PCOS and NCAH. Total testosterone levels were 0.40 [0.20\u20130.60], 0.59 [0.45\u20130.94], and 0.20 [0.15\u20130.20] ng\/mL in the PCOS, NCAH, and control groups, respectively, and androstenedione levels were 1.40 [1.20\u20132.20], 2.55 [1.64\u20134.07], and 0.87 [0.56\u20131.00] ng\/mL, respectively; both were higher in the patient groups than in controls (both p &lt; 0.001), without differing between PCOS and NCAH. Basal 17-OHP was the only parameter distinguishing NCAH from both PCOS and controls (p &lt; 0.001). Dehydroepiandrosterone sulfate (DHEAS) levels were 356.5 [217\u2013422], 292 [156\u2013448], and 219 [146\u2013240] \u00b5g\/dL, respectively (p = 0.020), with a significant difference only between PCOS and controls. Anti-M\u00fcllerian hormone (AMH) levels were 3.27 [3.02\u20134.13], 3.13 [2.87\u20133.54], and 3.34 [2.93\u20135.37] ng\/mL, respectively, with no between-group difference (p = 0.600). Other metabolic parameters, gonadotropins, estradiol, and prolactin showed no between-group differences. The principal hormonal findings remained unchanged after excluding women receiving oral contraceptives or glucocorticoids. Conclusions: In this PCOS cohort, in which 66.7% of women were classified as having non-NIH Rotterdam phenotypes, PCOS and NCAH showed substantial clinical, metabolic, and hormonal overlap, whereas basal early-follicular 17-OHP was the only parameter that consistently distinguished NCAH from both PCOS and healthy controls. These findings support the inclusion of basal 17-OHP in the evaluation of women presenting with hyperandrogenism.<\/jats:p>","DOI":"10.3390\/jcm15176522","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:47:19Z","timestamp":1787572039000},"page":"6522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, Metabolic and Hormonal Overlap Between Nonclassic Congenital Adrenal Hyperplasia and Polycystic Ovary Syndrome: An Exploratory Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9137-1963","authenticated-orcid":false,"given":"Arzu","family":"Yavuz","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kocaeli City Hospital, University of Health Sciences, Kocaeli 41060, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3646-6991","authenticated-orcid":false,"given":"Aylin","family":"Coskun","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3779-1075","authenticated-orcid":false,"given":"Dilara Tekin","family":"Uzman","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8361-8866","authenticated-orcid":false,"given":"Esra","family":"Hatipoglu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"ref_1","first-page":"17455057231160940","article-title":"Polycystic ovarian syndrome among women diagnosed with infertility in the Gulf Cooperation Council countries: A protocol for systematic review and meta-analysis of prevalence studies","volume":"19","author":"Alam","year":"2023","journal-title":"Women\u2019s Health"},{"key":"ref_2","first-page":"e20593","article-title":"Cutaneous Manifestations and Hormonal Changes Among Polycystic Ovary Syndrome Patients at a Tertiary Care Center","volume":"13","author":"Aljefri","year":"2021","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J. 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