# Insights From Liquid Chromatography-Mass Spectrometry-Measured Androgens in Indian Women With Polycystic Ovary Syndrome

## TL;DR

The study finds that androstenedione (A4) measured by LC-MS/MS is more effective than testosterone in diagnosing PCOS in Indian women.

## Contribution

This study highlights the diagnostic potential of androstenedione in PCOS using LC-MS/MS, which may improve detection accuracy.

## Key findings

- A4 had the highest diagnostic accuracy (AUC of 0.89) for PCOS compared to testosterone.
- Many PCOS patients with normal testosterone levels had elevated A4 or DHEA.
- A4 levels were significantly higher in PCOS-D phenotype compared to controls.

## Abstract

Introduction: Hyperandrogenemia is the defining feature of polycystic ovary syndrome (PCOS). Increasingly androgens are being advocated to be measured through liquid chromatography-mass spectrometry (LC-MS/MS). The role of LC-MS/MS over immunoassay in diagnosis of PCOS has been debated over a long time. We analyzed the role of androgens as measured by LC-MS/MS in diagnosing women with PCOS.

Materials and methods: We performed a prospective case-control study involving 59 women with PCOS compared with 30 age- and BMI-matched controls.

Results: In PCOS phenotypes A-C (hyperandrogenic by definition), 19/47 (40%) had normal testosterone (T) levels but 14/19 (75%) had either elevated androstenedione (A4) or dehydroepiandrosterone. A4 had the highest area under curve (0.89) for diagnosing PCOS followed by T (0.81). Even in the PCOS-D phenotype (sonologic polycystic ovaries + oligomenorrhoea), A4 was significantly higher as compared to controls though still in normal range.

Conclusion: A4 had a role in diagnosing hyperandrogenism in women with PCOS. Further studies clarifying the role of androgen profiles in diagnosing PCOS and its cost-effectiveness may be required in the future.