Combined oral contraceptives plus spironolactone compared with metformin in women with polycystic ovary syndrome: a one-year randomized clinical trial. Ethinylestradiol30μg-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome? CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials. Correlation of biochemical markers and clinical signs of hyperandrogenism in women with polycystic ovary syndrome (PCOS) and women with non-classic congenital adrenal hyperplasia (NCAH) Effect of oral contraceptive containing ethinyl estradiol combined with drospirenone vs. desogestrel on clinical and biochemical parameters in patients with polycystic ovary syndrome. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions Relationship Between Androgen Levels and Blood Pressure in Young Women With Polycystic Ovary Syndrome Comparison of two oral contraceptive forms containing cyproterone acetate and drospirenone in the treatment of patients with polycystic ovary syndrome: a randomized clinical trial Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives. Comparison of spironolactone and spironolactone plus metformin in the treatment of polycystic ovary syndrome Effect of ethinylestradiol/cyproterone acetate on endothelial function in young non-obese women with polycystic ovary syndrome: a pilot study Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome. Efficacy of an oral contraceptive containing drospirenone in the treatment of women with polycystic ovary syndrome Evidence for insulin suppression of baseline luteinizing hormone in women with polycystic ovarian syndrome and normal women. Modified Ferriman-Gallwey hirsutism score and androgen levels in Turkish women.
OBJECTIVE We aim ed to compare a combined oral contraceptive ( COC ) plus the anti and rogen spironolactone with the insulin sensitizer metformin in women with polycystic ovary syndrome ( PCOS ) . DESIGN We conducted a r and omized , parallel , open-label , clinical trial comparing COC ( 30 μg of ethinylestradiol and 150 μg of desogestrel ) plus spironolactone ( 100 mg/day ) with metformin ( 850 mg b.i.d . ) for one year in women with PCOS ( EudraCT2008 - 004531 - 38 ) . METHODS The composite primary outcome included efficacy ( amelioration of hirsutism , and rogen excess and menstrual dysfunction ) and cardiometabolic safety ( changes in the frequencies of disorders of glucose tolerance , dyslipidemia and hypertension ) . A complete anthropometric , biochemical , hormonal and metabolic evaluation was conducted every three months and data were su bmi tted to intention-to-treat analyses . RESULTS Twenty-four patients were assigned to COC plus spironolactone and 22 patients to metformin . Compared with metformin , COC plus spironolactone caused larger decreases in hirsutism score ( mean difference 4.6 points , 95 % CI : 2.6 - 6.7 ) , total testosterone ( 1.1 nmol/L , 0.4 - 1.7 ) , free testosterone ( 25 pmol/L , 12 - 39 ) , and rostenedione ( 5.5 nmol/L , 1.8 - 9.2 ) and dehydroepi and rosterone sulfate ( 2.7 μmol/L , 1.4 - 4.0 ) . Menstrual dysfunction was less frequent with COC plus spironolactone ( OR : 0.06 , 95 % CI : 0.02 - 0.23 ) . No differences were found in frequencies of abnormal glucose tolerance ( OR : 1.7 , 95 % CI : 0.7 - 4.4 ) , dyslipidemia ( OR : 0.6 , 95 % CI : 0.2 - 1.8 ) or hypertension ( OR : 0.3 , 95 % CI : 0.5 - 2.0 ) . No major adverse events occurred and biochemical markers were similarly safe with both treatments . CONCLUSIONS COC plus spironolactone was more effective than metformin for symptoms of PCOS showing similar safety and overall neutral effects on cardiometabolic risk factors Background We are hereby investigating for the first time the effect of the association ethinylestradiol30μg-drospirenone 3 mg ( DRP/EE30μg ) plus metformin and weight loss on endothelial status and C-reactive protein ( hsCRP ) levels in polycystic ovary syndrome ( PCOS ) . Methods 25 young women with PCOS ( mean age 22.76 ± 0.83 years , body mass index ( BMI ): 28.44 ± 6.23 ) who completed the study were prospect ively evaluated . The oral contraceptive- DRP/EE30μg ( 21 days/month ) and metformin ( 1700 mg daily ) were administered for 6 months to the PCOS group . Additionally , the 15 overweight and obese patients ( BMI > 25 kg/m2 ) were instructed in a diet of no more than 1500 cal daily . Primary outcome measures were surrogate markers of cardiovascular disease and included endothelial function , i.e. flow-mediated dilatation ( FMD ) on the brachial artery and endothelin-1 levels , as well as hsCRP concentrations , body composition ( measured by whole-body dual-energy X-ray-absorptiometry ) and insulin resistance . Variables were assessed at baseline , as well as after our medical intervention . Results The combination between DRP/EE30μg plus metformin combined with weight loss triggered a significant improvement in the FMD values ( FMD-PCOSbasal 3.48 ± 1.00 vs FMD-PCOS6 months7.43 ± 1.04 , p = 0.033 ) , as well as body composition and insulin insensitivity ( p < 0.05 ) . Regarding hsCRP levels , there was no significant intragroup ( PCOS6months – PCOSbasal ) difference . Conclusion A 6-month course of metformin- DRP/EE30μg ( associated with weight loss ) improves the endothelial dysfunction in PCOS and shows neutral effects on hsCRP concentrations as an inflammation marker . These data dem and for reevaluation of the medical therapy in PCOS , particularly in women with additional metabolic and cardiovascular risk factors ( Clinical Trials.gov Identifier : NCT01459445 ) Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Background : Polycystic ovary syndrome ( PCOS ) is the most common cause of hyper and rogenism in women . Non-classic congenital adrenal hyperplasia ( NCAH ) is very close to PCOS . The diagnosis of hyper and rogenism is not based on the finding of decreased or increased levels of a single hormone . Objective : In our paper , we are going to test correlation between clinical signs and biochemical markers of hyper and rogenism . Material s and Methods : In this prospect i ve study , we calculated  free testosterone ( cFT ) , bioavailable testosterone ( cBT ) , free and rogen index ( FAI ) , free estrogen index ( FEI ) , total testosterone ( TT ) , sex-hormone binding globulin ( SHBG ) , estradiol ( E2 ) , dehydroepi and rosterone-sulfat ( DHEA-S ) , 17α -hydroxyprogesterone ( 17α -OHP ) , prolactin ( P ) , C-peptid and homeostasis model assessment for insulin resistance ( Homa-IR ) were measured in two groups of young untreated women with PCOS and NCAH . Results : In our research , we did not find any significant differences between PCOS and NCAH groups by age , hormonal and calculated parameters of and rogens . Waist to hip ratio ( WHP ) and body mass index ( BMI ) values were higher in the group of patients with PCOS than NCAH group . But in all patients we found positive correlation between hirsutism score and FAI , cFT , cBT , as well as we found negative correlation between hirsutism score and SHBG . We also tested hormonal and calculated parameters of and rogens between PCOS patients by upper body and lower body obesity , but we did not find any significant differences . There was not any difference by the hirsutism score in these groups either . Conclusion : In our research we found that the calculated values of cFT , cBT and FAI are helpful for determinate hirsutism score in all hirsute patients , despite of ovarian or adrenal hyper and rogenemia BACKGROUND A prospect i ve r and omized trial was conducted to compare efficacy of a drospirenone-containing combined oral contraceptives ( COC ) with desogestrel-containing COC in women with polycystic ovary-syndrome ( PCOS ) not desirous of child-bearing . STUDY DESIGN Sixty women were r and omized into study group [ ethinylestradiol ( EE ) 30 mcg+drospirenone 3 mg ] and control group ( EE 30 mcg+desogestrel 150 mcg ) , treated for 6 months and followed up at 1 month , 3 months , 6 months , during treatment and 3 and 6 months post-treatment . Acne and hirsutism scoring , bodyweight , body mass index ( BMI ) , blood pressure ( BP ) , ultrasound parameters , lipid profile , glycemic profile and hormonal profile were compared . RESULTS Cycles were regular in both groups during treatment . Effect of regular cycles persisted in 44.83 % ( 13/30 ) vs. 17.24 % ( 5/30 ) in study vs. control group at 6 months post-treatment with 33.3 % decreased hirsutism score in the study group ( versus no change in control group ) even at 6 months after stopping treatment . With treatment , BMI fell by 0.52 kg/m(2 ) in the study group ; systolic and diastolic BP fell in the study group while it rose in the control group . Low-density lipoprotein significantly decreased and high-density lipoprotein was elevated in the study group ( p<.05 ) . The study group showed a significant fall in fasting/postpr and ial blood sugar and insulin and total testosterone against a rise in the control group . CONCLUSION In women with PCOS , a drospirenone containing COC has better outcome in terms of persistent regular cycles , anti and rogenic effect , fall in BMI and BP , better lipid profile , favorable glycemic and hormonal profile than desogestrel-containing COC Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies The role of testosterone on the development of hypertension is controversial , especially in women with polycystic ovary syndrome ( PCOS ) who have higher prevalence of obesity and insulin resistance than women without PCOS . Little is known about the association between serum testosterone level and blood pressure in young women with PCOS . In the 151 young Taiwanese women with PCOS enrolled in this cross-sectional study , we measured the body mass index , waist circumference , blood pressure , fasting glucose , fasting insulin , lipid profile , and hormone profiles .  The  free and rogen index , total testosterone , and sex hormone-binding globulin  , but not the level of dehydroepi and rosterone sulfate  , significantly correlated with both systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) . In multiple linear regression models adjusted for age , body mass index , and other anthropometric , metabolic , and hormonal variables , the level of serum free and rogen index  or total testosterone , but not the sex hormone-binding globulin , were independently related to SBP and DBP . The age- and body mass index – adjusted least-square mean of serum-free and rogen index levels were significantly different between the highest quartile and other quartiles of the SBP and DBP levels . The high bioavailable testosterone levels ( free and rogen index : ≥19 % ) in women with PCOS increased the risk of elevated blood pressure ( SBP ≥130 mm Hg and /or DBP ≥85 mm Hg ) with an odds ratio of 3.817 ( P=0.029 ; 95 % CI : 1.14 to 12.74 ) after adjustment for age , anthropometric measures , and metabolic profiles . Our results suggest that the characteristic hyper and rogenemia in young women with PCOS was associated with an elevated SBP and DBP independent of age , insulin resistance , obesity , or dyslipidemia Purpose To compare the effects of combined oral contraceptives ( OCs ) containing cyproterone acetate and drospirenone in the treatment of polycystic ovary syndrome ( PCOS ) . Methods Fifty-two patients with PCOS were r and omized in two groups : group A ( n = 26 ) received 0.035 mg ethinyl estradiol + 2 mg cyproterone acetate and group B ( n = 26 ) received 0.03 mg ethinyl estradiol + 3 mg drospirenone-containing OCs for 12 months . Baseline clinical features including body mass index , waist to hip ratio ( WHR ) , and modified Ferriman-Gallwey ( mFG ) score were noted . Baseline biochemical parameters included and rogen profile , carbohydrate metabolism , lipid profile , and oxidative stress . The percentages of changes for all parameters were compared . Results The groups were comparable regarding the baseline characteristics . WHR decreased significantly from baseline ( −4 % [ −31 to 35 ] ) in group B when compared to group A ( 0 % [ −11 to 14 ] ) ( P = 0.033 ) . The total mFG score decreased significantly from baseline ( −35 % [ −71 to 10 ] ) in group A when compared to group B ( −18 % [ −72 to 30 ] ) ( P = 0.035 ) . Changes in and rogen hormone profile were comparable except DHEA-SO4 ( −32 % [ −53 to 15 ] in group B vs. −10 % [ −49 to 63 ] in group A ; P = 0.046 ) . The effects of the drugs were similar regarding carbohydrate metabolism , lipid profile , and oxidative stress parameters . Conclusions Cyproterone acetate containing OCs seem to be more effective to treat clinical hirsutism in patients with PCOS after 12 months of treatment OBJECTIVE To compare the effects of cyproterone acetate and desogestrel , as part of combined oral contraceptives , on lipid metabolism and  hirsutism of adolescents with polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve r and omized clinical trial . SETTING Outpatient gynecology clinic ( referral center ) of a university . PATIENT(S ) Twenty-eight adolescent girls with clinical and biological hyper and rogenism and six or less menses during the past 12 months . INTERVENTION(S ) Group A ( n = 14 ) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl estradiol daily . Group B ( n = 14 ) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl estradiol daily . Treatment was given for 21 days followed by a 7-day rest for a period of 12 months . MAIN OUTCOME MEASURE(S ) Hirsutism and lipid profile were evaluated before initiation and at 3 , 6 , 9 , and 12 months of treatment . And rogen profile was evaluated before and at 12 months of treatment . RESULT ( S ) A significant decline of the Ferriman-Gallway hirsutism score was observed from the sixth month of therapy in both groups . During therapy , the levels of testosterone , free testosterone , Delta(4)- and rostenedione , and 17OH-progesterone decreased significantly , whereas sex hormone-binding globulin ( SHBG ) increased significantly in both groups . The level of total cholesterol and low density lipoprotein ( LDL ) cholesterol increased significantly , whereas high density lipoprotein ( HDL ) cholesterol and apolipoprotein A-I increased significantly from the third month of therapy in both groups . Total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios remained unchanged . The levels of triglycerides increased significantly in the cyproterone acetate-treated group after the third month . CONCLUSION ( S ) Treatment of adolescent girls with PCOS with the two studied formulations is comparably effective in decreasing hirsutism and and rogen levels . Both combined oral contraceptives are associated with an increase of total cholesterol , LDL cholesterol , and HDL cholesterol levels and no change of the total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios . Treatment with the cyproterone acetate combined oral contraceptive is associated with a tendency toward increasing the levels of triglycerides Abstract The aim of this study was to evaluate and compare the effects of spironolactone and spironolactone plus metformin treatments on body mass index ( BMI ) , hirsutism score , hormone levels , and insulin resistance in women with polycystic ovary syndrome ( PCOS ) . Thirty-seven patients with PCOS were r and omly assigned to receive spironolactone 100 mg/d ( spironolactone group , 18 patients ) or spironolactone 100 mg/d plus metformin 2000 mg/d ( combination group , 19 patients ) for 12 months . BMI , modified Ferriman – Gallway score ( FGS ) , serum levels of regarding hormones , and homeostasis model assessment of insulin resistance ( HOMA-IR ) index were assessed before and after the treatments . Six patients in the spironolactone group and four patients in the combination group reported inter-menstrual vaginal bleeding during treatments . In hirsutism scores , the spironolactone therapy result ed in 25.2 % reduction , while combination therapy result ed in 28.3 % reduction ( p > 0.05 , between groups ) . When the groups were compared in terms of percent changes in BMI , FGS , HOMA-IR , and hormone values other than free testosterone , no significant difference was noted . In the present study , FGSs were significantly decreased in both groups ; however , combination therapy was not more effective than spironolactone alone in terms of BMI , FGS , hormone levels , or insulin resistance Background . Combined oral contraceptives are used in polycystic ovary syndrome ( PCOS ) women for the treatment of hyper and rogenism and menstrual cycle disturbances . Aim . To assess the effect of ethinylestradiol and cyproterone acetate ( EE/CA ) on endothelial function in young , non-obese PCOS women in a pilot study . Methods . Thirteen young , non-obese PCOS women ( 20.9 ± 3.7 years , 23.0 ± 4.0 kg/m2 ) received 35 mcg EE & 2 mg CA for 6 months . Fourteen age- and body mass index ( BMI ) -matched healthy women served as controls . Endothelial function assessed by brachial artery flow-mediated dilation ( FMD ) , indices of hyper and rogenism , and insulin resistance were studied at baseline and 6-month follow-up . Results . FMD was impaired in PCOS compared to control women ( 4.67 ± 2.38 % vs. 10.12 ± 3.19 % , p < 0.001 ) , but increased significantly following EE/CA ( 9.99 ± 2.11 % , p < 0.001 vs. baseline ) , reaching normal values ( p = NS vs. controls ) . EE/CA also significantly decreased hyper and rogenism indices and increased total and HDL cholesterol and triglycerides ( p < 0.05 vs. baseline ) . The only independent predictor of treatment-induced FMD improvement in PCOS women was the decrease in free and rogen index . Conclusions . Treatment with combination of estrogens and anti and rogens reverses endothelial dysfunction in young , non-obese PCOS women mainly via improving hyper and rogenism . Further research is needed to investigate whether this treatment may also reduce cardiovascular risk in these women OBJECTIVE To compare the effects of oral contraceptive pills containing desogestrel , cyproterone acetate , and drospirenone , in polycystic ovary syndrome ( PCOS ) , after 6 and 12 months of therapy . DESIGN Double-blind r and omized controlled trial . SETTING Gynecologic clinic of the first author . PATIENT(S ) Women ( n = 171 ) with PCOS ( And rogen Excess Society criteria , 2006 ) . INTERVENTION(S ) The three-arm trial involved 58 , 56 , and 57 cases in desogestrel , cyproterone acetate , and drospirenone groups , respectively . Body mass index , abdominal circumference , hirsutism score ( modified Ferriman Galwey ) , acne and acanthosis nigricans scores , and blood pressure were noted . Blood levels of total T , sex hormone-binding globulin , fasting glucose , and fasting insulin were measured . Free and rogen index , glucose-insulin ratio , and homeostasis model assessment -insulin resistance were calculated . Follow-up was after 6 and 12 months of treatment . MAIN OUTCOME MEASURE(S ) Primarily , absolute change in the Free And rogen Index score between the three groups and , secondarily , changes in the clinical and other hormonal and biochemical parameters were studied . RESULT ( S ) Six months of treatment showed similar effects . After 12 months , cyproterone acetate significantly decreased the modified Ferriman Galwey score ( change = -5.29 ) compared with both desogestrel ( change = -1.69 ) and drospirenone ( change = -2.12 ) ; cyproterone acetate significantly increased sex hormone-binding globulin ( change = 142.91 ) compared with desogestrel ( change = 99.53 ) ; drospirenone significantly increased sex hormone-binding globulin ( change = 131.52 ) compared with desogestrel ; and cyproterone acetate significantly decreased the Free And rogen Index ( change = -10.57 ) compared with desogestrel ( change = -5.58 ) . CONCLUSION ( S ) No difference in effects after 6 months . At 12 months , cyproterone acetate showed the strongest anti and rogen activities . Effects on metabolic parameters were identical . CLINICAL TRIAL REGISTRATION NUMBER CTRI/2010/091/000332 Objective To investigate the efficacy of a combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone in the treatment of hyper and rogenism affecting women with the polycystic ovary syndrome ( PCOS ) . Methods Prospect i ve open study of 20 women for six cycles . At the beginning and at the end of the study the following values were determined : the Ferriman – Gallwey ( F – G ) score , body mass index , waist/hip ratio , serum levels of testosterone , SHBG , immune reactive insulin ( IRI ) , glucose , the free and rogenic index , and insulin resistance ( HOMA-IR ) . Results All 20 women completed six cycles of therapy . The medication was well tolerated . At the end of the study there was a significant improvement of hirsutism , expressed in the decrease of the F – G score , accompanied by a decrease of testosterone and an increase of SHBG values . The carbohydrate metabolism was not affected significantly . Conclusion The combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone is an effective drug in the treatment of hyper and rogenism in women with PCOS ; it elicits few side effects and does not significantly influence insulin resistance CONTEXT In women with polycystic ovarian syndrome ( PCOS ) , the relationship of insulin to LH secretion and responses to GnRH remains unresolved . A rigorous analytical examination of this relationship has not been performed . OBJECTIVE Our objective was to determine the relationship of basal LH secretion and responses to GnRH , insulin , and other endocrine variables in normal and PCOS women . DESIGN In PCOS and normal women , mean composite 12-h LH secretion was analyzed for correlating factors . LH responses to varying doses of GnRH during a fixed rate of insulin infusion and LH responses to a fixed dose of GnRH during varying doses of insulin infusion were analyzed for contributing factors . PATIENTS AND SETTING Eighteen PCOS and 21 normal women underwent studies of frequent blood sampling  and GnRH stimulation before and during insulin infusion  at the General Clinical Research Center , University of California , San Diego . MAIN OUTCOME MEASURES Group mean composite 12-h LH levels were assessed with respect to other endocrine variables . In addition , LH responses to GnRH with or without insulin infusion were assessed . RESULTS In normal women , insulin negatively predicted mean LH . In PCOS , the combined effect of body mass index ( negative ) and testosterone ( positive ) predicted LH . The best predictor of LH was body mass index and insulin combined . Basal LH and LH responses to GnRH were unaltered by insulin infusion in normal women . These measures were reduced during insulin infusion in PCOS women . CONCLUSIONS In PCOS , insulin infusion suppresses pituitary response to GnRH . In normal women , insulin negatively correlates with mean LH and suppresses GnRH response at a high infusion rate OBJECTIVE ( S ) To evaluate a modified Ferriman-Gallwey ( mFG ) scoring system and serum total testosterone ( tT ) and dehydroepi and rosterone sulfate ( DHEAS ) levels , in women with polycystic ovary syndrome ( PCOS ) and in control subjects . STUDY DESIGN Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic in the Mediterranean region of Turkey were assessed prospect ively . Oligo-anovulation , clinical and biochemical hyper and rogenism , and PCO appearance on ultrasound that met the 2003 Rotterdam Consensus Criteria were used for PCOS diagnosis . Group 1 consisted of 43 cases with a diagnosis of PCOS and group 2 ( control group ) consisted of 75 age and BMI matched control subjects without PCOS . RESULTS In groups 1 and 2 , clinical hyper and rogenism ( hirsutism ) appearance ratio was 86.0 % ( 37/43 ) and 18.0 % ( 15/75 ) ( p < 0.001 ) ; while biochemical hyper and rogenism ( high serum tT or DHEAS level ) was 65.1 % ( 28/43 ) and 36 % ( 27/75 ) ( p < 0.05 ) , respectively . In groups 1 and 2 , mean serum tT levels were 115.2 and 73.4 ng/dL ( p < 0.001 ) , mean serum DHEAS levels were 256.1 and 177.7 ng/dL ( p < 0.001 ) , and mean hirsutism scores were 11.2 and 5.5 ( p < 0.001 ) , respectively . Serum mean tT , DHEAS and hirsutism scores for group 1 were significantly higher than those of group 2 ( < 0.001 ) . No correlation was observed between BMI and the hirsutism scores or the biochemical hyper and rogenism in both groups . CONCLUSION ( S ) In our study , mean serum and rogen levels and hirsutism ratio in the PCOS group were higher than the control group . These values were also substantially higher than those previously published in the literature
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