Hyperandrogenism Linked to Low BMI in Polycystic Ovary Syndrome

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Hyperandrogenism occurs more frequently in patients with polycystic ovary syndrome (PCOS) who have BMIs that are less than 27, according to a study published in the Journal of Clinical Endocrinology & Metabolism.

Lower BMI in patients with PCOS were associated with increased luteinizing hormone (LH), androstenedione (A4), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) levels compared with patients with PCOS and higher BMIs, reported Carlos Moran, MD, MSc, of the Mexican Institute of Social Security in Mexico City, and colleagues.

The researchers sought to discover if there was a relationship between adrenal hyperandrogenism, which affects approximately 25% of patients with PCOS, and obesity in patients with the disease.

The study included 136 patients with PCOS aged 20 to 35 years and 42 age-matched controls. The participants were stratified into four groups with a BMI cutoff of 27: high-BMI PCOS patients, low-BMI PCOS patients, high-BMI controls and low-BMI controls. The researchers took blood samples to measure LH, follicle-stimulating hormone (FSH), insulin, testosterone, A4, DHEA, DHEAS and glucose levels.

The researchers found that obese patients with PCOS had significantly more insulin resistance than nonobese patients with PCOS. 

In low-BMI PCOS patients, LH, A4 and DHEAS levels as well as LH/FSH ratios were significantly higher compared with high-BMI PCOS patients. 

Low-BMI PCOS patients had a higher frequency of hyperandrogenism by increased A4 and high DHEA/DHEAS levels compared with high-BMI PCOS patients.

Hyperandrogenism Linked to Low BMI in Polycystic Ovary Syndrome
Hyperandrogenism Linked to Low BMI in Polycystic Ovary Syndrome

Objective: To assess dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) levels in relation to body mass index (BMI) in PCOS.

Results: Obese PCOS patients presented significantly more insulin resistance than non-obese PCOS patients. The LH levels and LH/FSH ratio were significantly higher in low-BMI than in high-BMI PCOS patients. The A4 and DHEAS levels were significantly higher in non-obese than in obese PCOS patients. A significant correlation between LH and A4 in non-obese PCOS patients was observed. The frequency of hyperandrogenism by increased A4, and DHEA along with DHEAS was significantly higher in low-BMI PCOS patients compared to high-BMI PCOS patients. Some findings observed with the BMI cutoff value of 27 kg/m2 changed with the cutoff value of 30 kg/m2.

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