Figure 13.

Two affected phenotypes in sisters of women with PCOS. Approximately 40% of the sisters of women with PCOS have hyperandrogenemia with similar T elevations (middle graph). About half of these affected women fulfill NICHD criteria for PCOS; the remaining hyperandrogenemic (HA) sisters have regular menses and normal fertility, suggesting that their menstrual cycles are ovulatory. Sisters with the PCOS phenotype are heavier (left graph) and more insulin resistant [significantly increased homeostasis model assessment of insulin resistance (HOMA IR), right graph] than sisters with the HA phenotype and sisters with normal androgen levels and regular menses (unaffected, UA). Black bars, PCOS; gray bars, HA; hatched bars, UA; open bars, reproductively normal control women. One-way ANOVA was applied, *, P < 0.05 vs. HA and UA; **, P < 0.05 vs. PCOS and HA; ***, P < 0.05 vs. PCOS, HA, and UA; †, P < 0.05 vs. UA and control; ††, P < 0.05 vs. control. [Adapted from R. S. Legro et al.: Insulin resistance in the sisters of women with polycystic ovary syndrome: association with hyperandrogenemia rather than menstrual irregularity. J Clin Endocrinol Metab 87:2128–2133, 2002 (443), with permission. © The Endocrine Society.]