Hormonal
Elevated serum androstenedione (A) is a stronger predictor of insulin resistance and metabolic dysfunction in women with Polycystic Ovary Syndrome (PCOS) than serum testosterone (T), with high A levels correlating to lower insulin sensitivity regardless of T status.
For women with PCOS, relying solely on testosterone levels may miss those at highest risk for insulin resistance and metabolic issues. Measuring androstenedione alongside testosterone provides a more complete picture of androgen excess and better predicts metabolic health risks.
Multiple linear regression showed a strong negative association between serum androstenedione and insulin sensitivity... no such association was observed between ISI and serum T, DHEAS, or DHEA.
Why this rating
Observational cross-sectional study with a decent sample size (n=86 PCOS, n=43 controls) and rigorous LC/MS-MS measurement, but lacks longitudinal causality.
Source
Hyperandrogenemia Predicts Metabolic Phenotype in Polycystic Ovary Syndrome: The Utility of Serum Androstenedione
Michael O’Reilly et al. · The Journal of Clinical Endocrinology & Metabolism · 2014
DOI 10.1210/jc.2013-3399
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