Regional differences in hormonal and metabolic parameters among women with polycystic ovary syndrome (PCOS) in California and Alabama indicate potential environmental impacts on PCOS, according to a study published in the Journal of Clinical Endocrinology & Metabolism. Katherine VanHise, MD, and colleagues conducted a prospective cohort study of 1,610 women with PCOS from 1987-2010. Women from Alabama with PCOS had a higher BMI, were younger, and were also more likely hirsute after adjustment for age and BMI (adjusted OR, 1.8), with elevated homeostatic model assessment for insulin resistance scores (adjusted beta coefficient, 3.6). Hyperandrogenemia was more likely among women from California with PCOS (adjusted ORs, 0.14 and 0.41 for free testosterone and total testosterone, respectively). When stratified by White race, results were similar. In Black women with PCOS, there was no difference in BMI and waist-to-hip ratio between locations, but differences in androgen profiles and metabolic dysfunction persisted.