 STUDY QUESTION: Which of the four abnormally elevated androgen groups total testosterone TT, androstenedione A4, free androgen index FAI, or dehydroepiandrosterone-sulfate DHEA-S present with an unfavorable metabolic and hormonal profile, appear to be more insulin-resistant and pose additional cardiovascular risk? SUMMARY ANSWER: Subjects with excess free androgen index tend to be obese and face the highest metabolic syndrome risk, adipocytokine alterations, insulin resistance IR and cardiovascular risk. The excess TT group presents with a marginal IR risk, while the excess A4 group has the highest antimüllerian hormone AMH, and may counterbalance obesity; this group and the excess DHEA-S group have a favorable association with IR. 