Serum uric acid/creatinine ratio and free androgen index are synergistically associated with increased risk of polycystic ovary syndrome in obese women

Abstract

Background Features of metabolic syndrome such as abdominal obesity, insulin resistance, hypertension and dyslipidemia are commonly encountered in polycystic ovary syndrome (PCOS). Recent evidence has suggested an association between high serum uric acid/creatinine (UA/Cr) ratio and metabolic syndrome however, no studies have investigated this association in PCOS. The current study was conducted to investigate the relationship between UA/Cr ratio and PCOS and to identify whether UA/Cr ratio and free androgen index (FAI) have an additive interaction for detection of PCOS risk in obese women. Methods This study enrolled 40 obese women with PCOS and 40 control women with regular menstrual cycles matched for age and body mass index (BMI). Anthropometric measurements, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipids profile, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), total testosterone, free androgen index (FAI), UA/Cr ratio were assessed. Results Serum UA/Cr ratio was significantly higher in obese women with PCOS than in non-PCOS women. UA/Cr ratio was correlated with BMI, waist and neck circumferences, blood pressure, fasting insulin, HOMA-IR, lipids, LH/FSH, estradiol, DHEAS, total testosterone, FAI and SHBG. UA/Cr ratio and FAI were independent risk factors for PCOS in obese women however, the addictive interaction between UA/Cr ratio and FAI had a higher fold risk (OR: 4.3, 95% CI, 3.4–7.58) and a more significance (P = 0.002) for determination of PCOS. Conclusion Serum UA/Cr ratio combined with FAI can exert an additive or synergistic impact on prediction of PCOS in obese women.

A nonlinear correlation between the serum uric acid to creatinine ratio and the prevalence of hypertension: a large cross-sectional population-based study

“…Furthermore, Moriyama reported that the UA/Cr ratio was closely related to metabolic syndrome and liver function in a large cohort study from Japan [ 25 ]. Another study showed that the serum UA/Cr ratio combined with the free androgen index could predict polycystic ovary syndrome in obese women [ 26 ]. In addition to these metabolic-related diseases, several studies have confirmed that the UA/Cr ratio is closely related to cardiovascular events and mortality.…”

Changes in the serum metabolomics of polycystic ovary syndrome before and after compound oral contraceptive treatment

“…Based on this speculation, the increase in uric acid levels may be related to ovulation dysfunction in PCOS, which elucidates the mechanism of ovulation dysfunction in PCOS from another perspective ( 26 , 28 , 29 ). In addition, in myocardial cells, high uric acid can lead to insulin resistance and inhibition of glucose metabolism, which may be the cause of long-term cardiovascular disease in patients with PCOS ( 30 ). Elevated serum uric acid levels are a common metabolic abnormality in PCOS, therefore, early prevention and treatment of PCOS are of great significance.…”

Obesity-Related Hypogonadism in Women

“…Consequently, serum uric acid was positively associated with visceral obesity, dyslipidemia, and hypertension ( 215 ). Interestingly, uric acid to creatinine ratio strongly correlated with free androgen index (r = 0.81) ( 216 ). Women with obesity and PCOS had significantly higher uric acid to creatinine ratio than those without PCOS ( 216 ).…”

“…Interestingly, uric acid to creatinine ratio strongly correlated with free androgen index (r = 0.81) ( 216 ). Women with obesity and PCOS had significantly higher uric acid to creatinine ratio than those without PCOS ( 216 ). The combination of uric acid to creatinine ratio and free androgen index increased the odds of PCOS in women with obesity by 4.3-fold (95% CI 3.4-7.6) ( 216 ).…”