Endocrine Abstracts

The National Institute of Health (US) recently organized an Evidence-based Methodology Workshop on the polycystic ovary syndrome (PCOS), focused on definition of the syndrome. Among others, the conclusions included the following: i) the need to assign a name that reflects the complex interactions that characterize the syndrome; ii) it is advisable to maintain a broad, inclusionary diagnostic criteria of Rotterdam, while specifically identifying the most common phenotype, characterized by androgen excess and ovulatory dysfunction; iii) the need to improve the methods and criteria used to assess androgen excess and develop an accurate assay for androgen levels; iv) it is necessary to improve the methods and criteria used to assess ovulatory dysfunction; v) it is necessary to investigate whether specific phenotypes of PCOS are associated with increased CV and diabetic complications. These recommendations intriguingly imply the need for further biomarkers. Potential biomarkers of ovarian dysfunction might be the measurement of blood levels of anti-Mullerian hormone and insulin like factor 3. The use of LM-MS/MS provides an important improvement in the assay of androgens. The combination of an extremely useful clinical parameter, acanthosis nigricans, combined with adiponectin and insulin blood levels may help in defining the presence of insulin resistance. Low sex hormone-binding globulin may be a marker of insulin and androgen excess and might predict the susceptibility to develop type 2 diabetes. Finally, consistent with the available literature on the role of low-grade inflammation in the pathophysiology of androgen excess and metabolic disturbances, measuring specific markers such as TNFα may help in characterizing specific phenotypes.