Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off > 1.0) and about 43% (n = 234) had hyperandrogenemia (TT > 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P < 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02-1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03-1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio.

Background: Both visceral adiposity index (VAI) and lipid accumulation product (LAP) can be used to assess insulin resistance (IR) and metabolic syndrome (MetS) which are required for management of even lean polycystic ovary syndrome (PCOS) (body mass index [BMI] <23 kg/m2). Aim: This study was aimed to see the magnitude of associations of VAI and LAP with cardiometabolic risk factors including IR and MetS in lean PCOS. Study Setting and Design: This cross-sectional study was done amongst 62 newly detected lean PCOS patients and 58 age- and BMI-matched healthy controls. Materials and Methods: PCOS was diagnosed according to the Revised 2003 Rotterdam Consensus criteria. Along with relevant clinical data, fasting blood was taken to measure glucose, insulin and lipid profile by glucose oxidase, chemiluminescent microparticle immunoassay and by glycerol phosphate dehydrogenase-peroxidase method, respectively. IR was calculated by homeostasis model of IR (HOMA-IR). VAI and LAP were calculated from BMI, waist circumference, triglyceride and high-density lipoprotein cholesterol by using sex-specific formulae. Statistical Analysis Used: Linear and binary regression analyses and receiver operating characteristics curve (ROC) analyses were done as appropriate. Results: Only LAP had predictive associations with age, systolic and diastolic blood pressure and total and low-density lipoprotein cholesterol. Both VAI and LAP had predictive associations with history of subfertility and MetS. LAP had moderate discriminating index for IR with cut-off of HOMA-IR of 2.3. Both VAI and LAP had excellent discriminating index for MetS in lean PCOS patients. Conclusions: LAP had more associations with cardiometabolic risks than VAI and was a moderate discriminator of IR in lean PCOS.

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Background: Androgen excess may correlate with metabolic risk in polycystic ovary syndrome (PCOS). The aim of the study was to determine the role of total testosterone to dihydrotestosterone (TT/ DHT) ratio in assessing the adverse metabolic outcome in PCOS. Methods:This cross-sectional study encompassed 40 PCOS women recruited on the basis of revised Rotterdam criteria 2003, and 40 agematched control subjects. TT, sex hormone binding globulin (SHBG) and insulin levels were measured by chemiluminescent microparticle immunoassay (CMIA) while DHT by enzyme-linked immunosorbent assay (ELISA). In addition, TT/DHT ratio, free androgen index (FAI), and insulin resistance (IR) by homeostatic model of assessment of insulin resistance (HOMA-IR) were calculated.Results: TT/DHT ratio was significantly higher in PCOS group than control group (P < 0.001). No significant difference was found for DHT (P = 0.261). PCOS patients had significantly higher TT (0.69 ± 0.26 vs. 0.30 ± 0.13 ng/mL; P < 0.001), FAI (P < 0.001) and low SHBG (P = 0.004) compared to controls. TT/DHT ratio was significantly higher in PCOS with impaired glucose tolerance (IGT) (P = 0.037) and metabolic syndrome (MetS) (P = 0.041). The best cutoff value for TT/DHT ratio to diagnose PCOS was observed to be 2.38 (sensitivity: 70%, specificity: 32.5% and area under the curve (AUC): 0.753). TT/DHT ratio also showed positive correlation with weight (r = 0.323, P = 0.042), waist circumference (WC) (r = 0.372, P = 0.018), HOMA-IR (r = 0.385, P = 0.014), 2-h post 75-g glucose (2h-PG), (r = 0.413, P = 0.008) and triglyceride (TG) level (r = 0.402, P = 0.010) in PCOS. Conclusions:There is a close relation between the TT/DHT ratio and adverse metabolic outcome in PCOS. Therefore, TT/DHT ratio may be considered as a predictor of adverse metabolic findings in PCOS.