{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:18:17Z","timestamp":1788153497090,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Polycystic ovary syndrome (PCOS) is frequently conceptualized as a hyperandrogenic disorder, yet cardiometabolic risk may be driven primarily by obesity and insulin resistance. We characterized glucose\u2013insulin dynamics in women with PCOS and examined whether metabolic dysfunction was more closely associated with obesity status than with androgen-related parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective cross-sectional study, 71 women with PCOS underwent a standardized 3-hour oral glucose tolerance test (OGTT, 0\u2013180 min) and were stratified by obesity status (BMI &amp;lt;30 kg\/m\u00b2, n=37; BMI \u226530 kg\/m\u00b2, n=34). OGTT-derived indices included the Matsuda index, HOMA-IR and AUCglucose\n                      <jats:sub>(0\u2013180)<\/jats:sub>\n                      . Associations were assessed using Pearson correlations and parsimonious multivariable linear regression models for log(Matsuda), log(HOMA-IR), and AUCglucose\n                      <jats:sub>(0\u2013180)<\/jats:sub>\n                      including BMI, age and total testosterone as predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Obese women were older and had higher fasting glucose than non-obese women, whereas HbA1c was only numerically higher. During the OGTT, they showed higher glucose and insulin concentrations, lower insulin sensitivity, higher fasting insulin resistance, greater glucose exposure, and a higher insulin response relative to glucose exposure. PCOM prevalence, Rotterdam phenotype distribution, moderate-to-severe hirsutism and menstrual grades were similar between groups. Total testosterone and adrenal androgens were comparable. Across the parsimonious model, BMI was the only consistent independent predictor of log(Matsuda), log(HOMA-IR), and AUCglucose\n                      <jats:sub>(0\u2013180)<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within this PCOS cohort, metabolic impairment was more closely associated with BMI and obesity status than with the androgen-related parameters assessed. These findings support metabolic risk stratification in PCOS focused on obesity and insulin resistance rather than broader androgen-related markers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1923923","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:28:07Z","timestamp":1788150487000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic dysfunction in women with PCOS is more closely linked to BMI than to hyperandrogenism"],"prefix":"10.3389","volume":"17","author":[{"given":"Paria","family":"Naderi","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birte","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"van Baal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Messner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"F\u00fchrer","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresia","family":"Sarabhai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, Medical Faculty and University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.4689131","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa839","article-title":"Update on PCOS: consequences, challenges, and guiding treatment","volume":"106","author":"Hoeger","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa029","article-title":"Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis","volume":"26","author":"Wekker","year":"2020","journal-title":"Hum Reprod Update"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2010.09.002","article-title":"Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis","volume":"16","author":"Moran","year":"2010","journal-title":"Hum Reprod Update"},{"key":"B5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.metabol.2017.09.016","article-title":"Polycystic ovarian syndrome (PCOS): long-term metabolic consequences","volume":"86","author":"Anagnostis","year":"2018","journal-title":"Metabolism"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1365.014","article-title":"Polycystic ovary syndrome is a risk factor for type 2 diabetes: results from a long-term prospective study","volume":"61","author":"Gambineri","year":"2012","journal-title":"Diabetes"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms030","article-title":"Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis","volume":"18","author":"Lim","year":"2012","journal-title":"Hum Reprod Update"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew243","article-title":"Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic-hyperinsulinaemic clamp studies","volume":"31","author":"Cassar","year":"2016","journal-title":"Hum Reprod"},{"key":"B9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1210\/clinem\/dgad356","article-title":"Adipose tissue dysfunction in polycystic ovary syndrome","volume":"109","author":"Bril","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12102313","article-title":"Comparing lean and obese PCOS in different PCOS phenotypes: evidence that the body weight is more important than the Rotterdam phenotype in influencing the metabolic status","volume":"12","author":"Carmina","year":"2022","journal-title":"Diagn (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.12.015","article-title":"Menstrual dysfunction in polycystic ovary syndrome: association with dynamic state insulin resistance rather than hyperandrogenism","volume":"115","author":"Ezeh","year":"2021","journal-title":"Fertil Steril"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-21-11-1440","article-title":"Clinical assessment of body hair growth in women","volume":"21","author":"Ferriman","year":"1961","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1977.tb15179.x","article-title":"Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex","volume":"97","author":"Ludwig","year":"1977","journal-title":"Br J Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.10.3666","article-title":"A critical evaluation of simple methods for the estimation of free testosterone in serum","volume":"84","author":"Vermeulen","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","article-title":"Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population","volume":"37","author":"Baldani","year":"2013","journal-title":"Coll Antropol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12008","article-title":"Prevalence of metabolic syndrome in women with polycystic ovary syndrome","volume":"78","author":"Panidis","year":"2013","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1210\/er.2012-1003","article-title":"Cardiometabolic aspects of the polycystic ovary syndrome","volume":"33","author":"Randeva","year":"2012","journal-title":"Endocr Rev"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1530\/ec-17-0239","article-title":"Adrenal hyperandrogenism does not deteriorate insulin resistance and lipid profile in women with PCOS","volume":"6","author":"Paschou","year":"2017","journal-title":"Endocr Connect"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02954.x","article-title":"Unravelling the phenotypic map of polycystic ovary syndrome (PCOS): a prospective study of 634 women with PCOS","volume":"67","author":"Diamanti-Kandarakis","year":"2007","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jsbmb.2009.12.010","article-title":"Insulin and hyperandrogenism in women with polycystic ovary syndrome","volume":"122","author":"Baptiste","year":"2010","journal-title":"J Steroid Biochem Mol Biol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.10.059","article-title":"Endothelial dysfunction in PCOS: role of obesity and adipose hormones","volume":"119","author":"Carmina","year":"2006","journal-title":"Am J Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"16057","DOI":"10.1097\/aog.0000000000002698","article-title":"Polycystic ovary syndrome","volume":"2","author":"Azziz","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"B23","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.fertnstert.2016.05.003","article-title":"Criteria, prevalence, and phenotypes of polycystic ovary syndrome","volume":"106","author":"Lizneva","year":"2016","journal-title":"Fertil Steril"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew218","article-title":"The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis","volume":"31","author":"Bozdag","year":"2016","journal-title":"Hum Reprod"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.1.165","article-title":"Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women","volume":"84","author":"Legro","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab392","article-title":"Women with polycystic ovary syndrome have an increased risk of major cardiovascular events: a population study","volume":"106","author":"Berni","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab613","article-title":"Health care-related economic burden of polycystic ovary syndrome in the United States: pregnancy-related and long-term health consequences","volume":"107","author":"Riestenberg","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1295","article-title":"Referral bias in defining the phenotype and prevalence of obesity in polycystic ovary syndrome","volume":"98","author":"Ezeh","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1530\/eje-15-0646","article-title":"Referral bias in female functional hyperandrogenism and polycystic ovary syndrome","volume":"173","author":"Luque-Ram\u00edrez","year":"2015","journal-title":"Eur J Endocrinol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1923923\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:28:08Z","timestamp":1788150488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1923923\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":29,"alternative-id":["10.3389\/fendo.2026.1923923"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1923923","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"article-number":"1923923"}}