Increased Ratio of Total Testosterone to Dihydrotestosterone May Predict an Adverse Metabolic Outcome in Polycystic Ovary Syndrome

Sukanti Shah, Hurjahan Banu, Tania Sultana, Nazma Akhtar, Afroza Begum, Begum Moriom Zamila, Md Fariduddin, Muhammad Abul Hasanat


Background: Androgen excess may correlate with metabolic risk in polycystic ovary syndrome (PCOS). The aim of the study was to determine the role of total testosterone to dihydrotestosterone (TT/DHT) ratio in assessing the adverse metabolic outcome in PCOS.

Methods: This cross-sectional study encompassed 40 PCOS women recruited on the basis of revised Rotterdam criteria 2003, and 40 age-matched control subjects. TT, sex hormone binding globulin (SHBG) and insulin levels were measured by chemiluminescent microparticle immunoassay (CMIA) while DHT by enzyme-linked immunosorbent assay (ELISA). In addition, TT/DHT ratio, free androgen index (FAI), and insulin resistance (IR) by homeostatic model of assessment of insulin resistance (HOMA-IR) were calculated.

Results: TT/DHT ratio was significantly higher in PCOS group than control group (P < 0.001). No significant difference was found for DHT (P = 0.261). PCOS patients had significantly higher TT (0.69 0.26 vs. 0.30 0.13 ng/mL; P < 0.001), FAI (P < 0.001) and low SHBG (P = 0.004) compared to controls. TT/DHT ratio was significantly higher in PCOS with impaired glucose tolerance (IGT) (P = 0.037) and metabolic syndrome (MetS) (P = 0.041). The best cutoff value for TT/DHT ratio to diagnose PCOS was observed to be 2.38 (sensitivity: 70%, specificity: 32.5% and area under the curve (AUC): 0.753). TT/DHT ratio also showed positive correlation with weight (r = 0.323, P = 0.042), waist circumference (WC) (r = 0.372, P = 0.018), HOMA-IR (r = 0.385, P = 0.014), 2-h post 75-g glucose (2h-PG), (r = 0.413, P = 0.008) and triglyceride (TG) level (r = 0.402, P = 0.010) in PCOS.

Conclusions: There is a close relation between the TT/DHT ratio and adverse metabolic outcome in PCOS. Therefore, TT/DHT ratio may be considered as a predictor of adverse metabolic findings in PCOS.

J Endocrinol Metab. 2019;9(6):186-192


PCOS; TT/DHT ratio; IGT; Metabolic syndrome; Insulin resistance; Obesity

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.