Stress In Polycystic Ovary Syndrome Research Articles

Oxidative stress in polycystic ovary syndrome: a case-control study.

To compare the serum levels of biochemical and oxidative stress markers i.e., malondialdehyde (MDA) and paraoxonase-1(PON1) in polycystic ovary syndrome (PCOS) patients and healthy female individuals of reproductive age group (18-40 years). This case-control study was conducted in Dow University of Health Sciences (DUHS), Karachi from June 2019 to October 2020. Seventy Subjects including 35 PCOS patients that have primary subfertility problem (cases) and 35 healthy and fertile females (controls) were recruited. Serum samples were collected for analysis of insulin, sex hormone-binding globulin, testosterone, fasting blood glucose and lipid profile. PON 1 and MDA levels were estimated by ELISA. Comparison between the two groups was done using independent t-test. The patients had significantly increased mean body mass index (28.5+4.6 kg/m2 vs 25.7+4.5 kg/m2, p=0.014), systolic (129.6±13.9 mm of Hg vs 113±7.7 mm of Hg, p<0.001) and diastolic (78.7±8.8 mm of Hg vs 74.6±6.7 mm of Hg, p=0.032) blood pressures compared to controls. The high-density lipoprotein cholesterol levels were significantly lower in PCOS (42.2±8.6mg/dl) than controls (48.8±11.8mg/dl, p=0.009, p=0.009). Serum insulin (14.3±5.8 uIU/mL) vs (10.0±5.2 uIU/mL), p=0.002 and testosterone levels (1.3±0.9 nmol/L) vs (0.82±0.3 nmol/L), p<0.001 were significantly higher whereas sex hormone binding globulin (SHBG) levels (35.2±19.7nmol/L vs 58.8±31.0 nmol/L) were significantly lower in patients than healthy controls (p<0.001). Both oxidative stress markers, paraoxonase 1 (7.7±2.4 vs 6.4±2.6 μg/mL, p=0.04) and malondialdehyde (2.5±1.0 vs 1.9+0.51μg/mL, p=0.034) levels were significantly elevated in PCOS patients than controls. No significant correlation was found between dietary habits and life style between cases and controls. The study reported significantly elevated levels of oxidative stress markers in PCOS patients.

Map4k4 is up-regulated and modulates granulosa cell injury and oxidative stress in polycystic ovary syndrome via activating JNK/c-JUN pathway: An experimental study

The regulatory mechanism on granulosa cells (GCs) oxidative injury is becoming increasingly important in polycystic ovary syndrome (PCOS) studies. Serine/threonine kinase mitogen-activated protein 4 kinase 4 (Map4k4) is linked with oxidative injury and possibly associated with premature ovarian failure and ovarian dysgenesis. Herein, we investigated the function and mechanism of Map4k4 in a PCOS rat model. A microarray from GEO database identified Map4k4 was up-regulated in the ovarian of PCOS rats, and functional enrichments suggested that oxidative stress-associated changes are involved. We verified the raised Map4k4 expression in an established PCOS rat model and also in the isolated PCOS-GCs, which were consistent with the microarray data. Map4k4 knockdown in vivo contributed to regular estrous cycle, restrained steroid concentrations and ovarian injury in PCOS rats. Both Map4k4 silencing in vivo and in vitro attenuated the PCOS-related GC oxidative stress and apoptosis. Mechanically, Map4k4 activated the JNK/c-JUN signaling pathway. Importantly, a JNK agonist restored the suppressive effects of Map4k4 silencing on PCOS-induced granulosa cell injury and oxidative stress. Besides, Map4k4 may be a target gene of miR-185-5p. In conclusion, Map4k4, a potential target of miR-185-5p, is up-regulated and induces ovarian GC oxidative injury by activating JNK/c-JUN pathway in PCOS. The Map4k4/JNK/c-JUN mechanism may provide a new idea on the treatment of PCOS.

A case-control study about markers of stress in normal-/overweight women with polycystic ovary syndrome and in controls.

Polycystic ovary syndrome (PCOS) is linked to an elevated risk of psychological disorders, decreased quality of life and emotional distress. Serum cortisol as a potential stress marker has been found to be increased in women with PCOS. The aim of this study was to evaluate both saliva stress markers and subjective psychological distress in women with PCOS. In a prospective case-control study, 31 PCOS women and 31 healthy controls were included. Salivary cortisol, and metanephrines were collected in the morning and in the evening. Emotional distress and quality of life were assessed by means of the Perceived Stress Scale (PSS-10) and the Short Form-36 (SF-36). Multivariable generalized linear models were applied to test the influence of various parameters on numerical outcome parameters. After correction for age and body mass index (BMI), there were no statistically significant differences of salivary biomarkers between PCOS women and healthy controls (p>0.05). PCOS patients revealed significantly higher increased PSS total scores and lower quality of life in all SF-36 modules apart from pain (p< 0.05). The PSS total score was positively correlated to prolactin in PCOS women (r= 0.450; p= 0.011). In overweight/obese PCOS patients, a higher BMI, a higher Ferriman Gallwey score and higher age significantly predicted the PSS total score (p< 0.05). Stress measured by salivary biomarkers did not differ between PCOS women and healthy controls, whereas stress scores evaluated by questionnaires were significantly greater in women with PCOS. A higher BMI, hirsutism and a higher age seem to be the main modulators of subjective stress in PCOS. Prolactin might serve as a biomarker for chronic stress in PCOS women.

Total antioxidant capacity and oxidative stress in Polycystic ovary syndrome, a case-control study

Total antioxidant capacity and oxidative stress in Polycystic ovary syndrome, a case-control study

The Key Role of Inflammation and Oxidative Stress in Polycystic Ovary Syndrome and Testicular Torsion: A Review of Their Induction in Rat Model

The Key Role of Inflammation and Oxidative Stress in Polycystic Ovary Syndrome and Testicular Torsion: A Review of Their Induction in Rat Model

Could sestrin protein in serum be a new marker of oxidative stress in patients with polycystic ovary syndrome?

Objective PCOS (polycystic ovary syndrome) is one of the most common endocrinological disorders and it is the threshold of many systemic disorders. There are many studies in the literature on the mechanisms that cause increased oxidation in PCOS. Sestrin protein is known to regulate the oxidation. In this study, it is aimed to examine the changes in the level of sestrin protein in women with PCOS. Methods A total of 60 women participated the study, 30 of whom were diagnosed with PCOS according to the Rotterdam criteria. Also, 30 women were included in the study as the control group. Demographic information, biochemical analysis results, and sestrin levels of the patients in each group were compared. Results The median sestrin level was 6.2 ± 0.8 in the PCOS group and 3.38 ± 0.4 in the control group (p < 0.001). As a result of the evaluation made with ROC analysis, it is observed that serum sestrin levels may be meaningful in the diagnosis of polycystic ovary syndrome. The area under the curve (AUC) value for the 4.69 level was 99.4% (p < 0.001, 95% CI: 96.7% vs. 100%, sensitivity: 100%, specificity: 96.7%). Conclusions Sestrin protein is associated with oxidative stress. Sestrin protein can be used as an indicator of increased oxidative stress in PCOS.

Abnormal Endometrial Receptivity and Oxidative Stress in Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women of childbearing age. Individual heterogeneity is evident, and the prevalence rate ranges between 6 and 15% globally. The prevalence rate of PCOS in Chinese women of childbearing age is 5.6%. The main manifestations are infertility, sparse menstruation, irregular vaginal bleeding, long-term endometrial hyperplasia, and endometrial cancer. PCOS is often associated with hyperandrogenemia, insulin resistance, hyperinsulinemia, obesity, metabolic syndrome, and intestinal flora disorder. Although there have been many studies in the past, the underlying pathophysiological mechanism of the disease is still unclear. Studies have shown that PCOS diseases and related complications are closely related to local oxidative stress imbalance in the endometrium, leading to poor endometrial receptivity and effects on pregnancy. Previous reviews have mainly focused on the abnormal mechanism of ovarian oxidative stress in women with PCOS, while reviews on endometrial receptivity and oxidative stress are relatively insufficient. This study reviews the abnormal cellular and molecular mechanisms of oxidative stress due to comorbidities in women with PCOS, leading to a downregulation of endometrial receptivity.

Psikoneuroimunologi Depresi pada Polycystic Ovary Syndrome (PCOS)

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Introduction&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: Polycystic ovary syndrome (PCOS) is heterogeneous, complex endocrine disorder with unknown etiology, affecting 4%−18% of reproductive age women and associated with reproductive, metabolic and psychological dysfunction. Along with physical disorders, many mental disorders are also associated with PCOS, about 40% of women with PCOS have depression. This literature review aims to explore how PCOS can lead to depression in term of psychoneuroimmunology aspects.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Method&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: Literature review was conducted through search engine from Google Scholar and Clinical Key with keywords “Polycystic ovary syndrome”, “depression”, “psychoneuroimmunology”, “distress”, and “inflammation” from 2015-2020.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Result&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: The important role of the HPG axis in the pathophysiology of mood disorder has concluded that high comorbidity between depression and PCOS are caused by hyperandrogenism and insulin resistance mediated by low grade chronic inflammation. The activation of HPA by stress exerts an inhibitory effect on the female reproductive system. CRH can inhibit GnRH secretion from the hypothalamus. The anti-reproductive action of CRH in the ovaries of women with high psychosocial stress lead to early ovarian failure. In addition, the pathophysiology of depression and mental stress in PCOS is associated with various changes including high activity of pro-inflammation markers and the body's immune system during stress, it has also been linked to increased cortisol levels, increased sympathetic activity and decreased serotonin levels in the central nervous system.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Result&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: There’s close relationship between PCOS and depression in terms of psychoneuroimmunology aspects, by HPG axis role. Comprehensive management of depression is improving outcome strategy in women with PCOS by involving CLP.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;strong&gt;Polycystic ovary syndrome (PCOS), Depression, Psychoneuroimmunology, HPG axis&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;

Inter relationship of sympathetic reflex response and oxidative stress in polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a very common reproductive endocrine disorder. Altered cardiovascular autonomic modulation and oxidative stress may predispose PCOS patients to cardiac events in the long term. Objective: To assess the relationship between sympathetic autonomic reactivity and oxidative stress in patients with polycystic ovary syndrome. Methods: This cross-sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from September 2018 to August 2019 on 35 newly diagnosed obese (BMI ≥25kg/m2) PCOS patients aged 20-35 years. Age and BMI matched 35 apparently healthy subjects were also enrolled. Two noninvasive conventional autonomic function tests, such as systolic blood pressure (SBP) fall during active standing and diastolic blood pressure (DBP) rise during sustained handgrip were conducted on all subjects for evaluation of sympathetic reactivity. For assessment of oxidative stress, plasma malondialdehyde level as oxidant and plasma catalase level as antioxidant were measured in all subjects by spectrophotometry. For statistical analysis Independent sample “t” test, Pearson’s correlation test and multiple regression analysis were done. Results: In this study PCOS patients had significantly higher resting heart rate, SBP and DBP than healthy control (p&lt;0.01). Fall of SBP during standing was significantly lower (p&lt;0.05) while rise of DBP during sustained handgrip was significantly higher (p&lt;0.05) in PCOS compared to healthy control. Plasma catalase level was significantly lower (p&lt;0.01) and plasma malondialdehyde level significantly higher (p&lt;0.001) in PCOS in comparison to healthy control. On correlation analysis, rise of DBP showed significant negative correlation (p&lt;0.05) with plasma catalase level in PCOS. On multiple regression analysis rise of DBP showed significant negative (p&lt;0.01) association with plasma catalase and significant positive (p&lt;0.01) association plasma malondialdehyde in PCOS. Conclusion: Based on these results it is concluded that measures of sympathetic reactivity were related to oxidative stress in PCOS. J Bngladesh Soc Physiol 2021;16(1): 61-69

Effects of salubrinal on ER stress in an experimental model of polycystic ovary syndrome

ABSTRACT This study aimed to investigate the role of endoplasmic reticulum (ER) stress in polycystic ovary syndrome (PCOS) and the effect of salubrinal (SAL) on this role. Animals were divided into four groups as control, PCOS, PCOS+SAL and SAL. Weights and serum testosterone levels were increased in the PCOS group while serum LH and ATF4 expressions were decreased. Morphometrically, number of follicles with a diameter between 150 and 300 µm were declined and number of follicles larger than 300 µm as well as the percentage of cystic follicles (CFs) were increased. Immunoreactivities of GRP78 and p-eIF2α were decreased, whereas oxidative stress (OS) dependent PAR expression was increased. Ultrastructurally, the PCOS group had no ER enlargement which was observed in the control group, while there were mitochondrial damage in granulosa cells (GCs). Elevated OS levels did not induce but rather decreased ER stress in GCs, and SAL injection in the PCOS model was ineffective on searched parameters. Since ER stress plays roles in certain physiological processes, we suggest that inhibitors of ER stress may not be always useful for reproductive tissues.

Role of Oxidative Stress in Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome is one of the most common causes of infertility. 6 to 8 percent of women of childbearing age have this endocrine disorder. Biochemical abnormalities in these patients lead to imbalance of female hormones and increased androgens, which can have consequences such as menstrual cycle disorder, hirsutism, acne vulgaris and androgenic alopecia. Despite the long history of studies on polycystic ovary syndrome, the cause is still unknown. Oxidative stress is an imbalance between the production of reactive oxygen species and the amount of antioxidant. When this balance is disturbed, the result is an increase in the level of oxidative stress. Oxidative stress is currently recognized as one of the major pathophysiologies of many disorders and diseases, including polycystic ovary syndrome. Understanding the mechanisms of oxidative stress is crucial for developing strategies for the prevention and treatment of this disease. In this article, we reviewed the data on the mechanism of oxidative stress in polycystic ovary syndrome.&#x0D;

Indicator of early kidney injury in adolescents with polycystic ovary syndrome: Can urine NGAL level be?

Introduction and Purpose The Urinary Neutrophil-gelatinase associated lipocalin (NGAL) levels which are a biomarker for early diagnosis of kidney damage that may develop in patients with Polycystic Ovary Syndrome (PCOS) were investigated in the study. Material and Methods The 30 patients diagnosed with Polycystic Ovarian Syndrome between the ages of 13 and 18 who applied to the Yuzuncu Yil University General Children's Outpatient Clinic were included in the PCOS group and 30 healthy adolescents without any known acute or chronic illness and drug use were included in the control group. Findings Urine NGAL value was 842.204 ± 21.561 in PCOS group and 775.379 ± 23.98 in control group. NGAL level in PCOS group was statistically significantly higher than control group (p: .045). When we examine the relationship between dyslipidemia and PCOS; While dyslipidemia was positive in 10 (33.7%) patients in the PCOS group, it was negative in 20 (66.7%) patients. While 1 patient had dyslipidemia, 29 patients did not have dyslipidemia in the control group. A significant relationship was found between dyslipidemia and PCOS (p: .005). Conclusion We found that subclinical kidney dysfunction started in early stage patients in PCOS in our study. The urine NGAL level was thought to increase in response to increased oxidative stress in PCOS. We found no relationship between, insulin resistance and urea, BUN, creatinine and NGAL levels. However, we found a negative correlation between NGAL level and LDL. In addition, dyslipidemia, insulin resistance and ALT elevation were detected in the PCOS group.

Relationship between parasympathetic reactivity and oxidative stress in Polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a very common reproductive hormone disorder. Altered cardiovagal autonomic modulation and oxidative stress may predispose PCOS patients to increased cardiovascular morbidity.&#x0D; Objective: To assess the relationship between parasympathetic reactivity and oxidative stress in patients with PCOS.&#x0D; Methods: This crosssectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka from September 2018 to August 2019 on 35 newly diagnosed obese (BMI ≥25kg/m2) PCOS patients aged 20-35 years. Age and BMI matched 35 apparently healthy women were also enrolled as control. Three noninvasive conventional autonomic function tests, such as heart rate response to deep breathing, standing and the Valsalva maneuver, were used for evaluation of parasympathetic reactivity. For assessment of oxidative stress, plasma malondialdehyde level (oxidant) and plasma catalase level(antioxidant) were measured in all subjects by spectrophotometry. Data were expressed as mean± SD. For statistical analysis Independent sample “t” test, Pearson’s correlation test and multiple regression analysis were done as applicable.&#x0D; Results: In this study PCOS patients had significantly higher (p&lt;0.01)resting heart rate, systolic and diastolic blood pressure than that of healthy control. But Expiration: Inspiration ratio, Expiration:Inspiration difference and 30:15 ratio during standing were significantly lower (p&lt;0.001, p&lt;0.01 and p&lt;0.05 respectively) in PCOS compared to control. In addition, plasma catalase level was significantly lower (p&lt;0.01)and plasma malondialdehyde level significantly higher (p&lt;0.001) in PCOS in comparison to healthy control. Multiple regression analysis showed plasma catalase as a significant positive predictor (p&lt;0.05) of the Valsalva ratio in PCOS. Also, Valsalva ratio showed significant negative association (p&lt;0.05) with plasma malondialdehyde (p&lt;0.01)in PCOS.&#x0D; Conclusion: Based on these results it is concluded that impaired parasympathetic reactivity showed inverse relationship with oxidative stress in PCOS.&#x0D; J Bangladesh Soc Physiol. 2019, December; 14(2): 48-55

Association between miRNAs Expression and Signaling Pathways of Oxidative Stress in Polycystic Ovary Syndrome.

Association between miRNAs Expression and Signaling Pathways of Oxidative Stress in Polycystic Ovary Syndrome.

Oxidative Stress and Polycystic Ovary Syndrome: A Brief Review.

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders, occurring in 5–10% women in reproductive ages. Despite a long history of studies on PCOS, its etiology is still unknown. Oxidative stress is now recognized to play a central role in the pathophysiology of many different disorders, including PCOS. Although intracellular reactive oxygen species (ROS) production and propagation are controlled by highly complex antioxidant enzymatic and non-enzymatic systems, understanding of mechanisms that oxidative stress is important to develop strategies for prevention and therapy of PCOS. This article reviews the literature data related to the mechanisms of oxidative stress in PCOS.

Depression, anxiety and perceived stress in women with and without PCOS: a community-based study.

Polycystic ovary syndrome (PCOS) is associated with increased psychological distress in clinical populations. We aimed to assess depression, anxiety and perceived stress in women with and without PCOS in a large community-based sample and investigate the role of stress in contributing to and mediating the relationship between PCOS, depression and anxiety. A cross-sectional analysis was performed from the Australian Longitudinal Study of Women's Health (ALWSH) comparing women with (n = 478) or without (n = 8134) a self-reported diagnosis of PCOS. Main outcome measures were depression, anxiety and perceived stress measured using validated scales. The χ2 and t tests were used to assess differences between groups. Univariable and multivariable regression were performed to determine factors contributing to each outcome. Women reporting PCOS, compared with women not reporting PCOS, reported higher prevalence of depression (27.3% v. 18.8%), anxiety symptoms (50% v. 39.2%) and greater score for perceived stress (1.01 ± 0.03 v. 0.88 ± 0.01). After adjusting for body mass index, infertility and socio-demographic factors, women with PCOS were still more likely to be depressed, anxious and to have a higher level of perceived stress. There was a high-level mediation effect of stress between PCOS and both depression and anxiety. Compared with women not reporting PCOS, women reporting PCOS have increased depression, anxiety and perceived stress. Stress may play a role in the association between PCOS, depression and anxiety. Further studies should consider assessment and management of stress in PCOS as it may be relevant for understanding the aetiology and treatment of psychological distress.

Evaluation of pro-oxidant-antioxidant balance (PAB) and its association with inflammatory cytokines in polycystic ovary syndrome (PCOS)

Chronic low-grade inflammation has been suggested as a key contributor of the pathogenesis and development of polycystic ovary syndrome (PCOS). To investigate the association between oxidative stress status and inflammatory cytokines in follicular fluid of 21 PCOS women compared to 21 women with normal ovarian function who underwent intra-cytoplasmic sperm injection. Concentration of IL-6, IL-8, IL-10, and TNF-α was measured using sandwich ELISA. Oxidative stress was examined by measuring total oxidant status (TOS), malondialdehyde (MDA), total antioxidant capacity (TAC), and thiol groups. PCOS women had an elevated concentration of MDA and TOS compared to controls. Levels of TAC and thiol groups were lower in PCOS compared to controls. PCOS patients had a higher concentration of IL-6, IL-8, and TNF-α compared to controls. Concentration of IL-10 was lower in PCOS compared to controls. Significant correlations were found between MDA and TOS concentration with TNF-α and between IL-6 and MDA, IL-8 and TAC, IL-10 and TOS levels and also between IL-10 and TAC levels. TAC and thiol groups were negatively correlated with TNF-α. Increased oxidative stress in PCOS is associated with inflammation which is closely linked. Inflammation can induce production of inflammatory cytokines in this syndrome and directly stimulates excess ovarian androgen production.

ABCA1 gene polymorphism and oxidative stress in polycystic ovary syndrome: Role of antioxidant therapy for prevention and control

Polycystic ovary syndrome (PCOS) is a common health problem that affects women in childbearing age. Recent studies discussed the relation of oxidative stress with PCOS and suggested that the antioxidants may improve the prognosis of PCOS. Changes happened in ATP binding cassette transporter 1 (ABCA1) gene encoding a protein regulating entry and exit from cell membrane may contribute to dyslipidemia in patients with PCOS. The role of oxidative stress and ABCA1 gene polymorphism in the pathogenesis of PCOS was evaluated along with the effect of antioxidants in the prevention and treatment of this disease. The present study included 90 female patients with PCOS and 90 healthy women represented the control group. Patients with PCOS were further divided into two subgroups. The patients included in subgroup 1a were treated with antioxidant and hormonal therapy while patients included in subgroup 1b were treated with hormonal therapy only. ABCA1gene polymorphism and oxidative stress parameters were investigated in all groups. The level of the oxidant marker; MDA was higher in PCOS patients when compared to controls. In addition, the levels of GSH, vitamin E, ascorbic acid, and selenium were significantly decreased, while SOD and GPx activities were increased in PCOS patients when compared to controls. The response to treatment among PCOS patients was better in group 1a than group 1b. The frequency of ABCA1 AA genotype was higher in PCOS patients than the control group (32.2% and 11.1% respectively). It was concluded that oxidative stress may lead to PCOS which raises the possibility of using antioxidants for the prevention and control of PCOS. In addition, the polymorphism in ABCA1 gene may be associated with genetic susceptibility for PCOS.

Serum activities of dipeptidyl peptidase-4 and adenosine deaminase and parameters of oxidative stress in polycystic ovary syndrome: association with obesity

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Oxidative stress status in Chinese women with different clinical phenotypes of polycystic ovary syndrome.

To determine oxidative stress status and its association with clinical and metabolic parameters in Chinese women with different clinical phenotypes of polycystic ovary syndrome (PCOS). A cross-sectional study. A total of 544 patients with PCOS and 468 control women were included. The total oxidant status (TOS) was determined using a microplate colorimetric method. Total antioxidant capacity (T-AOC), oxidative stress index (OSI, the ratios of TOS to T-AOC) and clinical, hormonal and metabolic parameters were also analysed. TOS and OSI were significantly higher in each of the four PCOS phenotypes based on the Rotterdam criteria than in the control women and higher in patients with hyperandrogenism (HA) than in those without HA (P < 0·05). TOS, T-AOC and OSI were higher in lean patients than in lean controls (P < 0·05). These values, except OSI, were also higher in overweight/obese patients than in lean patients, and lean or overweight/obese controls (P < 0·05). Multivariate regression analysis demonstrated that apolipoprotein (apo)A1, the Ferriman-Gallwey score, triglyceride (TG), oestradiol (E2 ), high-density lipoprotein cholesterol (HDL-C) and 2-h glucose levels were the main predictors of TOS; the Ferriman-Gallwey score, E2 , apoA1, TG and HDL-C levels were the main predictors of OSI. Patients with PCOS with HA have higher oxidative stress levels compared with those without HA. The increased oxidative stress in PCOS is related to HA status, increased plasma glucose, TG, HDL-C and E2 levels, decreased apoA1 concentrations and a relative shortage of antioxidant capacity.