['To determine whether the severity in hyperandrogenemia determines, to a significant degree, the severity of hirsutism in patients with polycystic ovary syndrome (PCOS).', 'Cross-sectional study.', 'Tertiary care academic referral center.', 'A total of 749 patients with PCOS.', 'History and physical examination, blood sampling.', 'Hirsutism defined by a value of >or=6 using the modified Ferriman-Gallwey (mFG) score, age, body mass index (BMI), calculated homeostatic assessment for insulin resistance (HOMA-IR) value, and levels of total (TT) and free (FT) testosterone, dehydroepiandrosterone sulfate (DHEAS) 17-hydroxyprogesterone (17OH-P), and fasting insulin (INS) and glucose (GLC).', 'Univariate correlations revealed associations between the mFG score and INS, 17OH-P, HOMA-IR, and BMI. Multivariate classification and regression tree analysis indicated that INS had the most significant association with mFG score and that at higher INS levels T played an additional role whereas at lower INS levels 17OH-P had an effect; however, this model accounted for only 8.2% of total variation in mFG score.'] Is degree of hyperinsulinemia , independent of androgen levels , an important determinant of the severity of hirsutism in PCOS?