# Male polycystic ovarian syndrome phenotype: a meta-analysis of endocrine-metabolic dysregulation in fathers and brothers of PCOS-affected women

## TL;DR

This study finds that fathers and brothers of women with PCOS show similar metabolic and hormonal issues, suggesting a male equivalent of the condition.

## Contribution

The study provides the first meta-analysis confirming a male PCOS phenotype through consistent metabolic and hormonal patterns in male relatives.

## Key findings

- Male relatives of PCOS-affected women had higher fasting glucose, BMI, triglycerides, and cholesterol compared to controls.
- They showed increased prevalence of hypertension, enlarged waist circumference, and androgenetic alopecia.
- Findings suggest a familial and genetic link to PCOS, with low to moderate heterogeneity across studies.

## Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women with potential familial and genetic components. Emerging evidence suggests that male first-degree relatives (fathers and brothers) may exhibit endocrine and metabolic abnormalities similar to a “male equivalent” of PCOS, although the condition remains without clear diagnostic criteria. We conducted a systematic review and meta-analysis to investigate whether male relatives of women with PCOS show consistent patterns of metabolic and hormonal dysregulation.

A total of 21 studies met inclusion criteria, encompassing male first-degree relatives of women with PCOS with available data on metabolic, hormonal, and cardiovascular outcomes. Meta-analysis showed that male relatives had significantly higher fasting blood glucose (MD: 6.25; 95% CI: 1.36–11.14), body mass index (1.18; 0.35–2.02), triglycerides (17.82; 10.82–24.81), total cholesterol (18.63; 6.16–31.10), LDL-cholesterol (12.99; 1.27–24.71), and dehydroepiandrosterone sulfate (1.29; 0.66–1.92) compared with controls. They also exhibited higher prevalence of hypertension (OR: 1.88; 1.18–2.29), waist circumference > 90 cm (3.27; 1.18–9.08), and androgenetic alopecia (1.65; 1.04–2.60). Findings were consistent across studies, with low to moderate heterogeneity and minimal publication bias.

Male first-degree relatives of women with PCOS demonstrate increased rates of metabolic abnormalities, hormonal imbalances, and androgenic features, supporting the concept of a male PCOS of equivalent. These findings underscore the familial nature of PCOS and highlight the need for improved diagnostic criteria and higher clinical awareness. Screening male relatives for metabolic and hormonal risk factors may help identify at-risk individuals and inform preventive interventions.

IR.SBMU.ENDOCRINE.REC.1403.146.