SAT-143 Free Testosterone as the Key Predictor of Hirsutism in PCOS: A Meta-Analysis

Abstract Disclosure: S. Younas: None. T. Jain: None. V.A. Mendpara: None. P.R. Patel: None. G. Palaniswamy: None. A.J. Augustine: None. B. Padamati: None. N. Koduri: None. K. Zulqadar: None. Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism, often leading to hirsutism. The correlation between androgen levels and hirsutism severity, measured by the Ferriman-Gallwey (FG) score, is inconsistent across studies. This meta-analysis quantifies the association between serum androgen levels and hirsutism severity in women with PCOS, while evaluating the influence of BMI, age, and ethnicity. Methods: A systematic search of PubMed, Embase, and Scopus (2010-2024) identified 14 studies (n=4,563 participants) assessing androgen levels (total/free testosterone, DHEAS) and hirsutism severity (FG score) in PCOS. A random-effects meta-analysis calculated pooled effect sizes, and heterogeneity was assessed using I² statistics. Results: The meta-analysis revealed a strong positive correlation between free testosterone and FG score (pooled r = 0.78-0.84, p < 0.001), confirming that higher free testosterone levels are associated with more severe hirsutism. Total testosterone showed moderate correlation (r = 0.18-0.75), while DHEAS had no consistent association with FG score. Subgroup analyses identified BMI, age, and ethnicity as key modifiers. Obese women exhibited higher androgen levels but variable hirsutism severity. Heterogeneity was low (I² = 0%), indicating consistency across studies. Conclusions: This meta-analysis confirms free testosterone as the primary androgen driving hirsutism severity in PCOS, while total testosterone and DHEAS demonstrate weaker or inconsistent correlations. BMI and ethnicity significantly influence the androgen-hirsutism relationship, emphasizing the need for personalized diagnostic and therapeutic approaches. Standardized androgen measurement and longitudinal studies are essential to improve PCOS-related hyperandrogenism assessment. Presentation: Saturday, July 12, 2025