The value of serum‐free androgen index in the diagnosis of polycystic ovary syndrome: A systematic review and meta‐analysis

Objective It is found that there is a significant difference in serum‐free androgen index (FAI) between patients with polycystic ovary syndrome (PCOS) and healthy people, and the selection of appropriate cutoff value has a certain diagnostic value for PCOS. However, the current research conclusions...

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Published inThe journal of obstetrics and gynaecology research Vol. 47; no. 4; pp. 1221 - 1231
Main Authors Wang, Lilin, Li, Juan
Format Journal Article
LanguageEnglish
Published Kyoto, Japan John Wiley & Sons Australia, Ltd 01.04.2021
Wiley Subscription Services, Inc
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ISSN1341-8076
1447-0756
1447-0756
DOI10.1111/jog.14681

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Summary:Objective It is found that there is a significant difference in serum‐free androgen index (FAI) between patients with polycystic ovary syndrome (PCOS) and healthy people, and the selection of appropriate cutoff value has a certain diagnostic value for PCOS. However, the current research conclusions on the diagnostic value of FAI for PCOS are not consistent. The purpose of this study is to explore the diagnostic value of FAI in PCOS, in order to provide reference for clinicians to select appropriate diagnostic indicators in the future. Methods Cochrane Library, Medline, Excerpta Medica Database, China National Knowledge Infrastructure, and China Wanfang database were searched until July 2020. A comprehensive collection of FAI studies on the diagnosis of PCOS was conducted. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), and negative likelihood ratio (−LR) were analyzed by Stata15.0 software, and the receiver operating characteristic (ROC) curves of the subjects were drawn. Results A total of seven high‐quality clinical studies were included. The results of meta‐analysis showed that the pooled sensitivity = 0.76 (95% confidence interval [CI]: 0.69 ~ 0.82), specificity = 0.82 (95%CI: 0.69 ~ 0.90), +LR = 4.12 (95%CI: 2.12 ~ 4.03), −LR = 0.29 (95%CI: 0.22 ~ 0.38), DOR = 14.08 (95%CI: 7.13 ~ 27.83), and the area under ROC was 0.84. Conclusion FAI has a moderate diagnostic value for PCOS. It may be possible to add new experimental designs to find the best cut‐off value for FAI diagnosis to improve the diagnostic efficacy.
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ISSN:1341-8076
1447-0756
1447-0756
DOI:10.1111/jog.14681