Endocrine Abstracts

Objective: Androsterone glucuronide (ADTG) concentrations have been suggested as a more reliable marker of the effects of androgen at the target tissue level and is significantly elevated in hirsute compared to non-hirsute women with PCOS. As the mechanism for hyperandrogenemia in obese and nonobese PCOS may differ, this study compares the different precursors of testosterone, including DHEAS, ADTG and androstenedione in nonobese compared to obese women with PCOS and their implications on cardiovascular risk.

Method: Eleven nonobese (BMI 22.9±1.4 kg/m²) and 40 age-matched obese (BMI 36.8±4.8 kg/m²) Caucasian women with PCOS were recruited using the Rotterdam criteria. Diabetes was excluded in all subjects by a 75 g oral glucose tolerance test. All subjects gave their informed consent and the study was approved by the local ethics committee. Fasting serum was collected at the same time each day and DHEAS, ADTG, androstenedione and total testosterone were analysed by isotope dilution liquid chromatography–tandem mass spectromentry (Waters Corporation, Manchester, UK).

Results: Both nonobese and obese PCOS were equally hyperandrogenic as measured by total testosterone level (1.70±0.66 vs 1.60±0.71 nmol/l, P=0.074), but DHEAS and androstenedione were significantly higher in nonobese compared to obese women with PCOS (7.64±2.33 vs 5.51±1.76 μmol/l, P<0.0001 and 7.25±2.82 vs 6.87±3.62 nmol/l, P=0.009 respectively). SHBG was significantly reduced in obese women with PCOS. Despite the much higher DHEAS in the nonobese group, ADTG levels were similar (213.7±82.3 vs 216.9±121.7 nmol/l, P=0.186). HOMA-IR significantly higher in obese PCOS compared to nonobese PCOS.

Conclusion: This study compared the different components of androgen levels between nonobese and obese women with PCOS and showed that nonobese PCOS patients have higher DHEAS and androstenedione concentrations compared to obese PCOS women, but both had surprisingly similar levels of ADTG.