{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:08:37Z","timestamp":1789549717769,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Aim: To investigate the association between body mass index (BMI) and gonadotropin secretion, including serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and the LH\/FSH ratio, among women with polycystic ovary syndrome (PCOS), and to compare these parameters with healthy women. Patients and Methods: This comparative cross-sectional analytical study included 400 women aged 18\u201335 years recruited from outpatient gynecology and endocrinology clinics at private-sector medical centers in Irbid, Jordan, between June 2025 and April 2026. The study included 200 women diagnosed with PCOS according to the Rotterdam criteria and 200 age-comparable healthy controls. The PCOS group was stratified into four BMI categories (&lt;25, 25\u2013&lt;28, 28\u2013&lt;31, and \u226531 kg\/m2), with 50 women in each category. Clinical and anthropometric characteristics were assessed, and serum LH and FSH concentrations were measured. The LH\/FSH ratio was calculated for each participant. Differences between groups were evaluated using appropriate statistical tests, while one-way analysis of variance was used to compare PCOS subgroups according to BMI. Pearson\u2019s correlation analysis was used to assess associations between BMI and gonadotropin parameters. Results: The mean age was comparable between women with PCOS and healthy controls (26.31 \u00b1 5.36 vs. 26.47 \u00b1 5.16 years; p = 0.23). Women with PCOS had significantly higher BMI than controls (27.85 \u00b1 3.47 vs. 22.81 \u00b1 2.29 kg\/m2; p &lt; 0.001). Among women with PCOS, menstrual irregularity, hirsutism, acne, infertility, and polycystic ovarian morphology were observed in 87.5%, 79.5%, 78.5%, 70.0%, and 100%, respectively. Serum LH was significantly higher in women with PCOS than in controls (8.44 \u00b1 2.61 vs. 6.53 \u00b1 1.16 IU\/L; p &lt; 0.001), whereas FSH was significantly lower (4.64 \u00b1 0.98 vs. 7.96 \u00b1 1.18 IU\/L; p &lt; 0.001), resulting in a higher LH\/FSH ratio (1.84 \u00b1 0.50 vs. 0.83 \u00b1 0.20; p &lt; 0.001). Within the PCOS group, LH progressively decreased across increasing BMI categories, from 11.58 \u00b1 1.26 IU\/L in women with BMI &lt; 25 kg\/m2 to 5.40 \u00b1 1.29 IU\/L in those with BMI \u2265 31 kg\/m2 (p &lt; 0.001). Similarly, the LH\/FSH ratio decreased from 2.46 \u00b1 0.18 to 1.28 \u00b1 0.23 across these BMI categories (p &lt; 0.001), whereas FSH did not differ significantly (p = 0.07). BMI showed strong inverse correlations with LH (r = \u22120.870, p &lt; 0.001) and the LH\/FSH ratio (r = \u22120.869, p &lt; 0.001), but not with FSH (r = \u22120.126, p = 0.075). Conclusions: Women with PCOS demonstrated a distinct gonadotropin profile characterized by higher LH and LH\/FSH ratio and lower FSH compared with healthy controls. Among women with PCOS, increasing BMI was strongly associated with lower LH concentrations and LH\/FSH ratios. These findings highlight the importance of considering BMI when interpreting gonadotropin profiles in PCOS, although prospective studies are required to determine whether changes in body weight directly influence gonadotropin secretion and reproductive outcomes.<\/jats:p>","DOI":"10.3390\/diseases14090341","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:58:59Z","timestamp":1789545539000},"page":"341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index-Related Alterations in Gonadotropin Secretion Among Women with Polycystic Ovary Syndrome Compared with Healthy Controls"],"prefix":"10.3390","volume":"14","author":[{"given":"Saad","family":"Al-Fawaeir","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Jadara University, Irbid 21110, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Deans, R. (2019). Polycystic ovary syndrome in adolescence. Med. Sci., 7.","DOI":"10.3390\/medsci7100101"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1210\/js.2019-00078","article-title":"Polycystic ovary syndrome: Pathophysiology, presentation, and treatment with emphasis on adolescent girls","volume":"3","author":"Witchel","year":"2019","journal-title":"J. Endocr. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sadeghi, H.M., Adeli, I., Calina, D., Docea, A.O., Mousavi, T., Daniali, M., Nikfar, S., Tsatsakis, A., and Abdollahi, M. (2022). Polycystic ovary syndrome: A comprehensive review of pathogenesis, management, and drug repurposing. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23020583"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7039","DOI":"10.1038\/s41598-022-11006-0","article-title":"Burden of polycystic ovary syndrome in the Middle East and North Africa region, 1990\u20132019","volume":"12","author":"Nejadghaderi","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"575","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":"ref_6","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s13224-024-01994-6","article-title":"Trends of Age at Onset of Menarche Among Indian Women of Reproductive Age and Its Association with the Presence of PCOS and Related Features: A Multicentric Cross Sectional Study: A. Shukla et al","volume":"75","author":"Shukla","year":"2025","journal-title":"J. Obstet. Gynecol. India"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.metabol.2018.11.002","article-title":"Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics","volume":"92","author":"Glueck","year":"2019","journal-title":"Metabolism"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.fertnstert.2024.10.028","article-title":"Polycystic ovarian syndrome, obesity, and insulin resistance: Intertwined comorbidities that impact assisted reproductive technology success","volume":"123","author":"Smigoc","year":"2025","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1001\/jama.2009.2014","article-title":"Prevalence and trends in obesity among US adults, 1999\u20132008","volume":"303","author":"Flegal","year":"2010","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1210\/jc.2003-031122","article-title":"Androgen excess in women: Experience with over 1000 consecutive patients","volume":"89","author":"Azziz","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1111\/jog.14132","article-title":"Phenotype and genotype of polycystic ovary syndrome in Asia: Ethnic differences","volume":"45","author":"Kim","year":"2019","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/cen.12784","article-title":"Clinical characteristics of polycystic ovary syndrome: Investigating differences in White and South Asian women","volume":"83","author":"Mani","year":"2015","journal-title":"Clin. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"887S","DOI":"10.1093\/jn\/131.3.887S","article-title":"Diet culture and obesity in northern Africa","volume":"131","author":"Mokhtar","year":"2001","journal-title":"J. Nutr."},{"key":"ref_14","unstructured":"WHO Consultation on Obesity (2000). Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation, World Health Organization. WHO Technical Report Series 894."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1210\/jc.2014-2569","article-title":"Adrenal androgen excess and body mass index in polycystic ovary syndrome","volume":"100","author":"Moran","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"620605","DOI":"10.1155\/2014\/620605","article-title":"Adrenocortical production is associated with higher levels of luteinizing hormone in nonobese women with polycystic ovary syndrome","volume":"2014","author":"Tock","year":"2014","journal-title":"Int. J. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"11795514231196461","DOI":"10.1177\/11795514231196461","article-title":"Prenatal androgen excess induces multigenerational effects on female and male descendants","volume":"16","author":"Abruzzese","year":"2023","journal-title":"Clin. Med. Insights Endocrinol. Diabetes"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8229","DOI":"10.1038\/s41598-024-58064-0","article-title":"Mechanism of elevated LH\/FSH ratio in lean PCOS revisited: A path analysis","volume":"14","author":"Pratama","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/IJBCRR\/2016\/21676","article-title":"LH\/FSH, BMI and clinical profile in polycystic ovarian syndrome: A correlative study","volume":"9","author":"Mobeen","year":"2016","journal-title":"Int. J. Biochem. Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S0015-0282(97)00551-7","article-title":"Relation of luteinizing hormone levels to body mass index in premenopausal women","volume":"69","author":"Bohlke","year":"1998","journal-title":"Fertil. Steril."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3329\/taj.v35i1.61147","article-title":"Correlation between BMI and LH level and LH\/FSH ratio-a cross-sectional study","volume":"35","author":"Parvin","year":"2022","journal-title":"TAJ J. Teach. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"The Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril., 81, 19\u201325.","DOI":"10.1016\/j.fertnstert.2003.10.004"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/ajum.12096","article-title":"Rotterdam criteria, the end","volume":"21","author":"Smet","year":"2018","journal-title":"Australas. J. Ultrasound Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/s41572-024-00511-3","article-title":"Polycystic ovary syndrome","volume":"10","author":"Teede","year":"2024","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"126","DOI":"10.31083\/j.ceog5105126","article-title":"Polycystic ovary syndrome (PCOS): Symptoms, causes, and treatment","volume":"51","author":"Bai","year":"2024","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ijgo.2013.09.025","article-title":"Prevalence of polycystic ovary syndrome among fertile and infertile women in Minia Governorate, Egypt","volume":"125","author":"Sanad","year":"2014","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ygcen.2017.12.007","article-title":"Evaluation of different ranges of LH: FSH ratios in polycystic ovarian syndrome (PCOS)\u2013Clinical based case control study","volume":"260","author":"Malini","year":"2018","journal-title":"Gen. Comp. Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"289","DOI":"10.5455\/medarh.2020.74.289-293","article-title":"Follicle stimulating hormone (LH: FSH) ratio in polycystic ovary syndrome (PCOS)-obese vs. non-obese women","volume":"74","author":"Saadia","year":"2020","journal-title":"Med. Arch."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1146\/annurev.med.52.1.401","article-title":"Current concepts in the polycystic ovary syndrome","volume":"52","author":"Dunaif","year":"2001","journal-title":"Annu. Rev. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1210\/jcem-30-4-435","article-title":"Inappropriate secretion of follicle-stimulating hormone and luteinizing hormone in polycystic ovarian disease","volume":"30","author":"Yen","year":"1970","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","first-page":"945","article-title":"Correlation of AMH and LH levels in PCOS patients with pregnancy rate","volume":"25","author":"Mohammed","year":"2021","journal-title":"Ann. Rom. Soc. Cell Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e230342","DOI":"10.1530\/JOE-23-0342","article-title":"Hormonal changes in PCOS","volume":"261","author":"Yang","year":"2024","journal-title":"J. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0950-351X(05)80286-1","article-title":"4 Hormones and obesity","volume":"8","author":"Kopelman","year":"1994","journal-title":"Baillieres Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1093\/humrep\/deq028","article-title":"Appropriate BMI levels for PCOS patients in Southern China","volume":"25","author":"Chen","year":"2010","journal-title":"Hum. Reprod."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Neubronner, S.A., Indran, I.R., Chan, Y.H., Thu, A.W.P., and Yong, E.-L. (2021). Effect of body mass index (BMI) on phenotypic features of polycystic ovary syndrome (PCOS) in Singapore women: A prospective cross-sectional study. BMC Women\u2019s Health, 21.","DOI":"10.1186\/s12905-021-01277-6"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s40618-016-0582-x","article-title":"Visceral adiposity index levels in overweight and\/or obese, and non-obese patients with polycystic ovary syndrome and its relationship with metabolic and inflammatory parameters","volume":"40","author":"Durmus","year":"2017","journal-title":"J. Endocrinol. Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/humupd\/dmg044","article-title":"Ultrasound assessment of the polycystic ovary: International consensus definitions","volume":"9","author":"Balen","year":"2003","journal-title":"Hum. Reprod. Update"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"20","DOI":"10.9790\/0853-1601012023","article-title":"To study the status of LH: FSH ratio in obese and non-obese patients of polycystic ovarian syndrome","volume":"16","author":"Lal","year":"2017","journal-title":"IOSR J. Dent. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/j.1365-2265.1990.tb00857.x","article-title":"Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: An analysis of 263 consecutive cases","volume":"32","author":"Kiddy","year":"1990","journal-title":"Clin. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.maturitas.2011.10.010","article-title":"Relationship of obesity-related disturbances with LH\/FSH ratio among post-menopausal women in the United States","volume":"71","author":"Beydoun","year":"2012","journal-title":"Maturitas"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"101","DOI":"10.5539\/gjhs.v7n2p101","article-title":"Body mass index and gonadotropin hormones (LH & FSH) associate with clinical symptoms among women with polycystic ovary syndrome","volume":"7","author":"Esmaeilzadeh","year":"2014","journal-title":"Glob. J. Health Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"197","DOI":"10.7555\/JBR.30.20140111","article-title":"Polycystic ovary syndrome patients with high BMI tend to have functional disorders of androgen excess: A prospective study","volume":"30","author":"Yuan","year":"2016","journal-title":"J. Biomed. Res."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Cai, J., Zhang, Y., Wang, Y., Li, S., Wang, L., Zheng, J., Jiang, Y., Dong, Y., Zhou, H., and Hu, Y. (2019). High thyroid stimulating hormone level is associated with hyperandrogenism in euthyroid polycystic ovary syndrome (PCOS) women, independent of age, BMI, and thyroid autoimmunity: A cross-sectional analysis. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00222"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2067087","DOI":"10.1155\/2016\/2067087","article-title":"Subclinical hypothyroidism in PCOS: Impact on presentation, insulin resistance, and cardiovascular risk","volume":"2016","author":"Yu","year":"2016","journal-title":"BioMed Res. Int."},{"key":"ref_45","first-page":"549","article-title":"Pattern of reproductive hormones (follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, and prolactin) levels in infertile women in Sagamu South Western Nigeria","volume":"4","author":"Olooto","year":"2012","journal-title":"Der Pharm. Lett."},{"key":"ref_46","first-page":"5","article-title":"Reproductive and biochemical changes in obese and non obese polycystic ovary syndrome women","volume":"51","author":"Mahmoud","year":"2015","journal-title":"Alex. J. Med."},{"key":"ref_47","first-page":"35","article-title":"Polycystic ovarian syndrome: The correlation between the LH\/FSH ratio and disease manifestations","volume":"12","author":"Alnakash","year":"2007","journal-title":"Middle East Fertil. Soc. J."},{"key":"ref_48","first-page":"24","article-title":"Polycystic ovarian syndrome in women with acne","volume":"22","author":"Begum","year":"2012","journal-title":"J. Pak. Assoc. Dermatol."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/9\/341\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:45:39Z","timestamp":1789548339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/9\/341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":48,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diseases14090341"],"URL":"https:\/\/doi.org\/10.3390\/diseases14090341","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]}}}