ASSOCIATION OF FREE ANDROGEN INDEX WITH LOW-GRADE INFLAMMATION IN DIFFERENT PHENOTYPES OF POLYCYSTIC OVARY SYNDROME

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with hyperandrogenism, insulin resistance, and chronic low-grade inflammation. This study evaluated the relationship between free androgen index (FAI) and inflammation across different PCOS phenotypes. Methods: In this hospital-based cross-sectional study, 330 women with PCOS diagnosed according to the modified Rotterdam criteria were classified into four phenotypes (A–D). Serum C-reactive protein (CRP), FAI, and HOMA-IR were measured and compared among phenotypes using appropriate statistical analyses. Results: Phenotype A was the most common (51.2%) and showed the highest CRP, FAI, and HOMA-IR values. CRP levels differed significantly among phenotypes (P=0.014), with elevated CRP most frequently observed in phenotype A (50.3%). FAI was positively correlated with HOMA-IR (r=0.255, P<0.001), but neither FAI nor HOMA-IR showed a significant association with CRP. Multivariable analysis confirmed that FAI, HOMA-IR, BMI, and age were not independent predictors of CRP. Conclusion: Hyperandrogenic PCOS phenotypes exhibit greater inflammatory and metabolic disturbances; however, FAI is not independently associated with systemic inflammation. These findings suggest that inflammation in PCOS is multifactorial and varies across phenotypes.