Association between Helicobacter pylori infection and hyperandrogenism in women with polycystic ovary syndrome.

INTRODUCTION

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction,and metabolic disturbances. Chronic low-grade inflammation and insulin resistance are key components of its pathophysiology.Helicobacter pylori (H. pylori) infection has been associated with systemic inflammation and metabolic alterations and may potentially affectendocrine function. The aim of this study was to assess whether H. pylori infection is associated with changes in hormonal parameters,including increased severity of hyperandrogenism, in women with PCOS.

MATERIAL AND

METHODS

A total of 150 patients aged 18-40 years were included and classified according to PCOS diagnosis and H. pyloriinfection status into four groups. PCOS was diagnosed based on the Rotterdam criteria. Active H. pylori infection was assessed usinga stool antigen test. Anthropometric measurements were obtained, and fasting blood samples were analyzed for hormonal (including totaland free testosterone, androstenedione, DHEAS, SHBG, LH, FSH, AMH, prolactin, cortisol) and metabolic parameters (glucose, insulin,HOMA-IR). Statistical analysis included non-parametric tests for between-group comparisons and categorical analyses, with correctionfor multiple comparisons where appropriate.

RESULTS

No significant differences in age, BMI, or WHR were observed between H. pylori-positive and H. pylori-negative groups. Amongpatients with PCOS, H. pylori infection was not associated with significant differences in androgen concentrations (total and free testosterone,androstenedione, DHEAS, 9FAI) or other hormonal parameters. No significant differences were observed in gonadotropins, AMH,prolactin, cortisol, or metabolic parameters, including glucose, insulin, and HOMA-IR. In patients without PCOS, minor differences inhormonal parameters were observed; however, these were not statistically significant after correction for multiple comparisons. The frequencyof abnormal laboratory results did not differ between groups.

CONCLUSIONS

In this cohort of young women, H. pylori infection, detected using a stool antigen test, was not associated with clinicallymeaningful alterations in androgen levels or ovarian reserve in women with PCOS. These findings suggest that the endocrine profile inPCOS is primarily determined by intrinsic pathophysiological mechanisms of the syndrome, which may mask the potential impact ofchronic H. pylori infection.