The role of testosterone in the development of AD in women is unclear, with a Mendelian randomization study suggesting that there was no association between testosterone and AD, though PCOS was not investigated in that study [45]; however, the results here suggest that further investigation is warranted, as the increase in APCS and the decrease in PAPPA related to testosterone may be protective [27,31]. Here, PAPPA is linked to polycystic ovary syndrome.