Endocrine Abstracts

Background: In polycystic ovary syndrome (PCOS), in response to stimulation by luteinizing hormone (LH), the ovarian theca cell synthesizes androgens. However, associations of serum androgen levels with metabolic parameters yet to be determined. We aimed to investigate these associations.

Methods: We retrospectively evaluated our outpatient admission records for PCOS, hirsutism, oligomenorrhea, or secondary amenorrhea. PCOS diagnosis was made after excluding other causes of hirsutism and in accordance with Rotterdam criteria. Patients to be included in the study required not to receive any medication for PCOS, or for other conditions associated with insulin resistance, within the last 6 months. Fasting serum glucose, insulin, FSH, LH, total and free testosterone, DHEA-S levels and lipid profile were studied. The correlations between these parameters were determined.

Results: Median fasting serum glucose levels of 167 women (median age 25, IQR 25 to 75, 21 to 30) participated in the study was 4.67 mmol/l (4.38 to 4.94), HOMA-IR index was 2.04 (1.44 to 3.78), HDL-C was 52.00 (41.00 to 62.75), LDL-C was 95.50 (80.25 to 119.00), triglyceride was 106.00 (76.00 to 150.50) mg/dl, total testosterone was 60.40 (40.17 to 93.58) ng/dl (normal, 6–82), free testosterone was 2.0 (1.45 to 2.80) pg/ml (normal, 0.29–3.18), DHEA-S was 263.90 (180.83 to 379.20) mcg/dl (normal, 35–430). Serum total testosterone levels correlated well with LH (r: 235, P: 0.021), whereas negatively correlated with LDL-C (r: −0.290, P: 0.021). Free testosterone levels correlated with insulin (r: 0.372, P: 0.003) and HOMA-IR index (r: 0.372, P: 0.005), while negatively correlated with HDL-C (r: −0.289, P: 0.018). Serum DHEA-S levels negatively correlated with LDL-C (r: −272, P: 0.023).

Conclusions: Androgen levels in women with PCOS may be manipulated with manipulation of metabolic parameters such as LDL-C and HDL-C and serum insulin levels. Specifically, manipulations to increase serum HDL-C may decrease the levels of free testosterone, the most bioavailable androgen.