Georgopoulos and colleagues reported that elevated A4 (>3.8 ng/mL) in women with PCOS is associated with a more severe phenotype, including elevated LH, LH:FSH ratio, T, DHEA-S, and free androgen index (FAI), as well as increased ovarian volume and greater mean number of follicles in hyperandrogenic women with PCOS [37]. The gene discussed is PLOD1; the disease is polycystic ovary syndrome.