Value of Free Androgen Index for Diagnosis of Hyperandrogenism in Polycystic Ovary Syndrome

【Objective】To explore the value of free androgen index for the diagnosis of hyperandrogenism in polycentric ovary syndrome in infertile patients in this region.【Method】Body mass index(BMI),basal sexual hormones,sex hormone-binding globulin(SHBG),fasting glucose(FPG),fasting insulin(FINS)were collected from 533 women with PCOS,aged 27.76±4.12,who were divided into two groups according to the body mass index(BMI):Obese PCOS group(n=109)and non-obese PCOS group(n=424),and 580 infertile women with normal ovulatory cycle were recruited as control group.Free androgen index(FAI) and homeostasis model assessment of insulin status(HOMA-IR)were used to assess hyperandrogenemia and insulin sensitivity separately.【Result】Compared with control group,PCOS group showed significantly elevated basic luteinizing hormone(LH) level,LH/follicle-stimulating hormone(FSH)ratio,FAI,FINS,HOMA-IR values,but decreased SHBG level than control group(P0.05).While,no significantly differences were found in total testosterone between two groups.The ideal threshold value for HOMA-IR,FAI and LH/FSH ratio were 1.95[AUC-ROC was 0.738(95%CI:0.707-0.769)],3.08[AUC-ROC was 0.792(95%CI:0.763-0.821)]and 1.1[AUC-ROC was 0.772(95%CI:0.741-0.801)].In the obese PCOS group,HOMA-IR had the highest sensitivity and negative predictive value(91.74%,83.63%separately),and was significantly higher than LH/FSH ratio(52.29%,50.94%separately)(P0.01),but there were no significant differences when compared with FAI(88.07%,76.36%separately).In non-obese PCOS group,LH/FSH ratio had the highest sensitivity and specificity(69.10%,79.0% separately),and was significantly higher than HOMA-IR(58.72%,68.60%separately)(P0.01),but there were no significant differences when compared with FAI either(68.87%,73.40%separately).【Conclusion】The diagnosis of hyperandrogenism in PCOS should be classified based on BMI,in addition to clinical manifestations and presence of polycystic ovaries.The main biochemical index for diagnosis of PCOS is FAI,it is superior to total testosterone,as it is ideal biochemical indicator shows serum testosterone and insulin sensitivity as well.It can be used in both the diagnosis and treatment of PCOS.