LAUSR

Large comparative studies of androgen profiles in women with polycystic ovary syndrome (PCOS) and healthy women are scarce, and the application of the free androgen index (FAI) in diagnosing PCOS has lagged behind in China. Androgen profiles of women aged between 19 and 45 years with PCOS (n = 833) were compared with controls (n = 2732). The women with PCOS had an elevated androgen level (total testosterone, androstenedione and free androgen index) through their reproductive years. In the 'healthy' reference population (consisting of 821 controls without PCOS and without disorders affecting androgen concentrations), FAI, total testosterone and androstenedione were weakly but negatively correlated with age. In women with PCOS, androstenedione was negatively correlated with age (r = -0.106; P = 0.002), whereas increased total testosterone and FAI, and decreased SHBG, were observed in the group aged 40-45 years. After adjusting for body mass index (BMI), age was negatively correlated with FAI and androstenedione, and positively correlated with sex hormone-binding globulin (SHBG) (all P < 0.001). Hyperandrogenaemia seemed to worsen in the oldest women with PCOS, which might be explained by the increasing BMI. About 1.9% of the PCOS control population was diagnosed with PCOS using the FAI upper limit of 6.0, determined by the 95th percentile of the 'healthy' reference group. Body weight management should be emphasized for women with PCOS throughout their lives, and assay of SHBG and FAI is highly recommended in China.