Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS)

Eleftherios P. Diamandis, Frank Z. Stanczyk, Sarah Wheeler, Anu Mathew, Martin Stengelin, Galina Nikolenko, Eli N. Glezer, Marshall D. Brown, Yingye Zheng, Yen Hao Chen, Hsiao Li Wu, Ricardo Azziz

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS. We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth-generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA. cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-To-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-The-receiver-operating-characteristic curve of 0.89. Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.

Original languageEnglish (US)
Pages (from-to)1789-1797
Number of pages9
JournalClinical Chemistry and Laboratory Medicine
Issue number11
StatePublished - Oct 26 2017


  • androgen-regulated genes
  • hirsutism
  • hyperandrogenism
  • polycystic ovarian syndrome
  • prostate specific antigen
  • serum biomarkers
  • urine biomarkers

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical


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