THE RELATIONSHIP OF FREE ANDROGEN INDEX (FAI) WITH INSULIN RESISTANCE IN DIFFERENT PHENOTYPES OF POLYCYSTIC OVARY SYNDROME

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting women of reproductive age. Hyperandrogenism and Hyperinsulinemia are key features of the syndrome. The present study aimed to assess the association between the free androgen index (FAI) and insulin resistance in different phenotypes of PCOS.

Methods: A total of 330 women aged 18–45 years diagnosed with PCOS according to the modified 2003 Rotterdam criteria were included. Participants were classified into phenotypes A, B, C, and D. Clinical, anthropometric, hormonal, biochemical parameters, and ultrasound features of all phenotypes were noted. FAI was calculated as total testosterone/sex hormone binding globulin × 100. Insulin resistance was assessed using homeostatic model assessment of insulin resistance (HOMA-IR). Phenotype wise comparisons and correlations between FAI and HOMA-IR were performed.

Results: Phenotype A was the most prevalent 51% followed by B (31%), C (11%), and D (7%). FAI showed a significant positive correlation with HOMA-IR in the overall study population (r = 0.255, P < 0.001). Phenotypes A and D showed significant correlations, whereas phenotypes B and C showed non-significant correlations. High FAI levels were observed in 259 participants (78.48%) and were significantly associated with the PCOS phenotypes (P < 0.001). Biochemical hyperandrogenism was highest in phenotype A, followed by B, C, and absent in phenotype D.

Conclusion: FAI was significantly associated with insulin resistance in women with PCOS. Phenotype-wise assessment improves the identification of metabolic risk in PCOS and helps in individualized clinical management.