Hyperandrogenemia is implicated in both the metabolic and reproductive morbidities of polycystic ovary syndrome

Abstract

Objective: To determine the features of polycystic ovary syndrome (PCOS) that are implicated in the associated reproductive and metabolic morbidities.

Design: Cross-sectional case-control study.

Setting: Academic medical setting.

Patient(s): A total of 1,062 women with PCOS and 1,887 women without PCOS.

Intervention(s): None.

Main outcome measure(s): Physical examination including hirsutism scoring, biochemical and hormone measurements, ovarian ultrasound, and a 75-g oral glucose tolerance test to measure glucose and insulin levels.

Result(s): A factor analysis identified four dominant factors in women with PCOS. These factors were interpreted as follows: [1] metabolic and hyperandrogenemia factor, [2] oligomenorrhea and hyperandrogenemia factor, [3] blood pressure factor, and [4] ovarian morphology factor. In women with PCOS, hyperandrogenemia was a significant predictor of metabolic syndrome after adjusting for age, body mass index, and insulin resistance in the regression analysis.

Conclusion(s): A factor analysis identified multiple factors that are responsible for the abnormalities associated with PCOS. Hyperandrogenemia was a common underlying feature of the metabolic and reproductive abnormalities in women with PCOS but not in women without PCOS.

Keywords: Hyperandrogenemia; metabolic morbidity; polycystic ovary syndrome; reproductive morbidity.