Homocysteine and androgen profiles show outcome-specific associations in PCOS patients with infertility, live birth, or spontaneous abortion.
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Key Takeaway
Note that HCY-androgen associations in PCOS vary by reproductive outcome, suggesting outcome-specific patterns rather than universal correlations.
This retrospective cohort study included 875 patients with polycystic ovary syndrome (PCOS) stratified by reproductive outcomes: infertility (n=302), pregnancy (n=573), live birth (n=266), and spontaneous abortion (n=292). The analysis focused on associations between homocysteine (HCY) and androgen profiles across these distinct clinical groups.
Metabolic disturbances were most pronounced in the infertile patient group, followed by the spontaneous abortion group. The live birth group exhibited the most favorable metabolic profile, with all group comparisons showing statistical significance (P < 0.05). In the infertile subgroup, HCY demonstrated broad positive correlations with multiple androgens, including independent associations with total testosterone (TT), bioavailable testosterone (Bio-T), free testosterone (FT), and the free androgen index (FAI) (beta = 0.12–0.21; all P < 0.01).
In the live birth group, HCY was independently positively associated with TT (beta = 0.30; P < 0.01). Conversely, in the spontaneous abortion group, HCY was independently negatively associated with dehydroepiandrosterone (DHEA) (beta = -0.16; P = 0.02). No adverse events, serious adverse events, discontinuations, or tolerability issues were reported in the study.
The study highlights that HCY-androgen associations in PCOS are reproductive outcome-specific. These divergent patterns may inform risk stratification across different reproductive stages. However, as an observational study, causal inferences cannot be drawn. The results warrant cautious interpretation regarding clinical management strategies for PCOS patients based on reproductive history.
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View Original Abstract ↓
BackgroundElevated homocysteine (HCY) and hyperandrogenism are key metabolic disturbances in polycystic ovary syndrome (PCOS), but their relationship across different reproductive outcomes remains unclear.ObjectiveTo investigate outcome-specific associations between HCY and androgen profiles in PCOS women with infertility, live birth, or spontaneous abortion.MethodsThis retrospective study enrolled 875 PCOS patients, classified into infertility (n=302) and pregnancy (n=573) groups. After excluding non-spontaneous pregnancy losses, the pregnancy group was further subdivided into live birth (n=266) and spontaneous abortion (n=292). Spearman correlation and multivariable linear regression were used to assess HCY-androgen associations.ResultsMetabolic disturbances were most pronounced in infertile patients, followed by the spontaneous abortion group, while the live birth group exhibited the most favorable metabolic profile (all P < 0.05). HCY-androgen correlations varied markedly across reproductive outcomes. In infertile patients, HCY showed broad positive correlations with multiple androgens, with regression analysis confirming independent associations with total testosterone (TT), bioavailable testosterone (Bio-T), free testosterone (FT) and free androgen index (FAI) (β = 0.12–0.21, all P < 0.01). These correlations narrowed substantially in pregnant women. Strikingly, a divergent pattern emerged within pregnancy subgroups: HCY was independently positively associated with TT in the live birth group (β = 0.30, P < 0.01), but independently negatively associated with dehydroepiandrosterone (DHEA) in the spontaneous abortion group (β = -0.16, P = 0.02).ConclusionThe HCY-androgen associations in PCOS are reproductive outcome-specific and may inform risk stratification across different reproductive stages.
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