Heterogeneity of Endocrinologic and Metabolic Parameters in Reproductive Age Polycystic Ovary Syndrome (PCOS) Women Concerning the Severity of Hyperandrogenemia—A New Insight on Syndrome Pathogenesis

Background: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, anovulation, infertility, obesity, and insulin resistance, which results in increased concentrations of testosterone (T), which disturbs follicular growth and ovulation. This study aimed to assess PCOS women’s clinical, endocrinological, and metabolic parameters concerning hyperandrogenism severity. Results: 314 women (mean age 27.3 ± 4.6; mean body mass index (BMI) 25.7 ± 5.6) with PCOS, were divided into terciles according to T concentrations: <0.64 ng/mL (group 1), 0.64 to 0.84 ng/mL (Group 2) and >0.84 ng/mL (group 3). The mean concentration of T in all women was 0.59 ng/mL and correlated negatively with the number of menstrual cycles per year (MPY) ( r = −0.36; p < 0.0001) and positively with Ferriman-Gallway score (FG) ( r = 0.33; p < 0.0001), luteinizing hormone (LH) ( r = 0.19; p < 0.0001) and dehydroepiandrosterone sulfate (DHEAS) ( r = 0.52; p < 0.0001). Positive correlation between BMI and hirsutism ( r = 0.16; p < 0.0001), total cholesterol (TC) ( r = 0.18; p < 0.0001), low-density lipoprotein (LDL) ( r = 0.29; p < 0.0001), and triglycerides (TG) ( r = 0.40; p < 0.0001) was demonstrated. The division into subgroups confirmed the lowest MPY, highest LH, and hirsutism in group 3. BMI, insulin sensitivity indices, and lipid profile parameters were not different between the three T subgroups. Conclusions: We found no correlation between testosterone levels and insulin sensitivity or dyslipidemia in women with PCOS. Metabolic abnormalities may contribute more significantly than hyperandrogenemia to PCOS development.