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<p>Polycystic ovary syndrome (PCOS), in which hyperandrogenism is a major feature, is the most prevalent endocrine disorder among women of reproductive age. Serum free testosterone (FT) reflects the biologically active fraction of circulating testosterone. Accurate assessment of FT allows for precise identification of hyperandrogenism and provides critical guidance for the diagnosis of PCOS. Women with PCOS and normal controls (NCs) were included in this study. Fasting serum samples were collected during the early follicular phase to evaluate key clinical parameters, and FT levels were quantified using liquid chromatography‒tandem mass spectrometry (LC‒MS/MS). The diagnostic value of FT for identifying PCOS was assessed using Spearman’s correlation analysis and receiver operating characteristic curves. A total of 202 women were included in the PCOS group, 121 were included in the NC group. Total testosterone (TT), free androgen index (FAI), and FT levels were significantly greater in the PCOS group than in the NC group. Both FAI and FT were positively correlated with body mass index (BMI), triglycerides, low-density lipoprotein cholesterol, fasting insulin and the homeostasis model assessment for insulin resistance; and were negatively correlated with high-density lipoprotein cholesterol. Following age and BMI adjustments, the area under the curve (AUC) for FT (AUC = 0.886) was greater than that for TT (AUC = 0.856) or FAI (AUC = 0.864). Compared with conventional assessments of TT and FAI, LC–MS/MS–based measurements of FT demonstrate superior diagnostic performance for identifying PCOS. Both FT and FAI are associated with obesity and the features of metabolic syndrome in PCOS patients.</p>

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Accurate Measurement of Serum Free Testosterone Levels via Liquid Chromatography‒Tandem Mass Spectrometry (LC‒MS/MS) has Predictive Value in the Diagnosis of Polycystic Ovary Syndrome and Associated Metabolic Disorders

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Yang Liu,
  • Cheng Li,
  • Jie Li,
  • Zhaolian Wei,
  • Xiangjuan Li,
  • Jun Peng,
  • Zhenzuo Jiang,
  • Bin Liu,
  • Yang Liu,
  • Hefeng Huang,
  • Li Jin

摘要

Polycystic ovary syndrome (PCOS), in which hyperandrogenism is a major feature, is the most prevalent endocrine disorder among women of reproductive age. Serum free testosterone (FT) reflects the biologically active fraction of circulating testosterone. Accurate assessment of FT allows for precise identification of hyperandrogenism and provides critical guidance for the diagnosis of PCOS. Women with PCOS and normal controls (NCs) were included in this study. Fasting serum samples were collected during the early follicular phase to evaluate key clinical parameters, and FT levels were quantified using liquid chromatography‒tandem mass spectrometry (LC‒MS/MS). The diagnostic value of FT for identifying PCOS was assessed using Spearman’s correlation analysis and receiver operating characteristic curves. A total of 202 women were included in the PCOS group, 121 were included in the NC group. Total testosterone (TT), free androgen index (FAI), and FT levels were significantly greater in the PCOS group than in the NC group. Both FAI and FT were positively correlated with body mass index (BMI), triglycerides, low-density lipoprotein cholesterol, fasting insulin and the homeostasis model assessment for insulin resistance; and were negatively correlated with high-density lipoprotein cholesterol. Following age and BMI adjustments, the area under the curve (AUC) for FT (AUC = 0.886) was greater than that for TT (AUC = 0.856) or FAI (AUC = 0.864). Compared with conventional assessments of TT and FAI, LC–MS/MS–based measurements of FT demonstrate superior diagnostic performance for identifying PCOS. Both FT and FAI are associated with obesity and the features of metabolic syndrome in PCOS patients.