To evaluate the relative importance of androgen and insulin concentrations in predicting body fat distribution, we measured their association with waist-hip ratio in a sample of 151 consecutively enrolled healthy premenopausal women age 18-24 years, after controlling for potential confounding variables. Dehydroepiandrosterone sulfate (DHEAS) and total testosterone were independently associated with waist-hip ratio, whereas insulin and free testosterone did not appear to play a role of comparable importance. Differences in concentrations of circulating DHEAS and total testosterone are independently associated with the waist-hip ratio in premenopausal women, providing epidemiologic support to the "neuroendocrine dysregulation" hypothesis for the pathogenesis of central obesity.