Abstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women with potential familial and genetic components. Emerging evidence suggests that male first-degree relatives (fathers and brothers) may exhibit endocrine and metabolic abnormalities similar to a "male equivalent" of PCOS, although the condition remains without clear diagnostic criteria. We conducted a systematic review and meta-analysis to investigate whether male relatives of women with PCOS show consistent patterns of metabolic and hormonal dysregulation. RESULTS: A total of 21 studies met inclusion criteria, encompassing male first-degree relatives of women with PCOS with available data on metabolic, hormonal, and cardiovascular outcomes. Meta-analysis showed that male relatives had significantly higher fasting blood glucose (MD: 6.25; 95% CI: 1.36-11.14), body mass index (1.18; 0.35-2.02), triglycerides (17.82; 10.82-24.81), total cholesterol (18.63; 6.16-31.10), LDL-cholesterol (12.99; 1.27-24.71), and dehydroepiandrosterone sulfate (1.29; 0.66-1.92) compared with controls. They also exhibited higher prevalence of hypertension (OR: 1.88; 1.18-2.29), waist circumference > 90 cm (3.27; 1.18-9.08), and androgenetic alopecia (1.65; 1.04-2.60). Findings were consistent across studies, with low to moderate heterogeneity and minimal publication bias. CONCLUSION: Male first-degree relatives of women with PCOS demonstrate increased rates of metabolic abnormalities, hormonal imbalances, and androgenic features, supporting the concept of a male PCOS of equivalent. These findings underscore the familial nature of PCOS and highlight the need for improved diagnostic criteria and higher clinical awareness. Screening male relatives for metabolic and hormonal risk factors may help identify at-risk individuals and inform preventive interventions. TRIAL REGISTRATION: IR.SBMU.ENDOCRINE.REC.1403.146.