Associations of Serum Phosphorus Concentrations with Insulin Resistance and Hyperandrogenemia in Normal Weight Women with Polycystic Ovary Syndrome

Purpose: Serum phosphorus is reported to be associated with insulin resistance (IR) and testosterone in many populations. However, studies exploring the role of serum phosphorus in polycystic ovary syndrome (PCOS) patients are rare. Thus, we aimed to investigate the associations of serum phosphorus concentrations with IR and hyperandrogenemia (HA) in women with PCOS. Methods: : This was a secondary analysis of a multicenter and large-sample clinical trial including 1000 PCOS subjects diagnosed by the modified Rotterdam criteria. A total of 508 normal-weight PCOS patients with available serum phosphorus data were enrolled in the present study. Serum phosphorus, metabolic indices, and total testosterone (TT) concentration were measured. IR status was defined by a homeostasis model assessment of insulin resistance (HOMA‐IR) ≥ 2.69, and HA status was defined as a TT level ≥ 1.67 nmol/L. Multivariable linear regression and logistic regression models were used to evaluate the associations of serum phosphorus with IR and HA. Results: : Multiple linear regression analysis showed that the serum phosphorus concentration was inversely correlated with fasting plasma glucose (FPG), fasting insulin (FIN), HOMA‐IR, and TT ( P trend < 0.05 for all) after adjusting for confounding factors. Logistic regression showed that the serum phosphorus concentration was negatively correlated with IR and HA status. The multivariable-adjusted odds ratios with 95% confidence intervals for IR and HA status for the lowest vs . the highest quartiles of serum phosphorus were 2.26 (1.17-4.35, P trend = 0.009) and 2.58 (1.48–4.51, P trend = 0.002), respectively. Conclusion: Our results demonstrated that lower serum phosphorus concentrations were associated with higher risk of IR and worsened HA in normal-weight women with PCOS.