Luteinizing Hormone to Follicle-Stimulating Hormone Ratio Significantly Correlates With Androgen Level and Manifestations Are More Frequent With Hyperandrogenemia in Women With Polycystic Ovary Syndrome

Abstract

Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off > 1.0) and about 43% (n = 234) had hyperandrogenemia (TT > 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P < 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02-1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03-1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio.

Early onset female pattern hair loss: A case–control study for analyzing clinical features and genetic variants

“…In the ovary, FSH promotes estrogen metabolism in granulosa cells, together with luteinizing hormone (LH) for androgen synthesis in theca cells. The ratio of LH/FSH levels is positively correlated with serum J o u r n a l P r e -p r o o f total testosterone levels in women [42]. Indeed, increased levels of LH/FSH were observed in men in the early AGA group [43].…”

Testosterone level correlates significantly with luteinizing hormone to follicle-stimulating hormone ratio among women with polycystic ovary syndrome: A cross sectional study

“…Morshed et al reported that 71.0% PCOS patients (cut-off more than1.0) exhibited an aberrant LH-FSH ratio. 16 According to Nath et al, 17 70.58% of women with PCOS have an increased LH-FSH ratio. As a result, the authors proposed that the LH-FSH ratio is one of the defining characteristics of PCOS women.…”

An Ovarian Steroid Metabolomic Pathway Analysis in Basal and Polycystic Ovary Syndrome (PCOS)-like Gonadotropin Conditions Reveals a Hyperandrogenic Phenotype Measured by Mass Spectrometry

“…Basal growth media consisted of 50% α-MEM Glutamax and 50% DMEM:F12 Glutamax supplemented with 3 mg/mL BSA, 0.5 mg/mL bovine fetuin, 5 mg/mL insulin, 5 mg/mL transferrin, 5 mg/mL selenium, and 0.5% penicillin-streptomycin. To study the effect of stimulation with different gonadotropin profiles, ovary explants were cultured in “G0” standard media (rhFSH only, “standard conditions”, n = 11 pooled across three biologic replicates), “G10” media with a physiologic ratio of gonadotropins (1:1 hCG:rhFSH [ 4 , 5 ], “physiologic conditions”, n = 12 pooled across three biologic replicates), or “G30” media with a pathophysiologic (PCOS-like) ratio of gonadotropins (3:1 hCG:rhFSH, “PCOS-like conditions”, n = 12 pooled across three biologic replicates). For all groups, ovulation was induced on culture day 14 by treating ovary explants for 14–16 hours with maturation media, consisting of 50% α-MEM Glutamax and 50% DMEM:F12 Glutamax with 10% FBS, 10 mIU/mL rhFSH, 1.5 IU/mL hCG, and 10 ng/mL epidermal growth factor.…”

“…A common observation is that patients with PCOS have increased levels of luteinizing hormone (LH), relative to levels of follicle-stimulating hormone (FSH) [ 3 , 4 , 5 ] and it has been hypothesized that this abnormal ratio of gonadotropins is the initial insult that drives PCOS pathogenesis. LH stimulates proliferation of theca cells and secretion of androgens [ 6 , 7 ].…”