Endocrine Abstracts

The measurement of androgens is critical for the diagnosis of polycystic ovary syndrome (PCOS) but it has been difficult based on poor specificity and sensitivity of assays in the female range. The direct total androgen activity can be measured with dihydrotestosterone equivalent concentration (DEQ) using chemically activated luciferase gene expression (CALUX) bioassays. The aim of the study is to determine whether DEQ levels can be the index for hyperandrogenemia to be required for diagnosis of PCOS. The study involved 100 women with PCOS and 100 healthy women with regular menstrual cycles. The initial evaluation including case history, anthropometrical data, excess facial and body hair and two-dimensional vaginal ultrasound was assessed. All hormonal investigations (T, total testosterone; A, androstenedione; fTc, calculated free testosterone from T and SHBG; DEQ levels by CALUX bioassay) were performed. A correlation of T (r=0.3912, P<0.001), A (r=0.41, P<0.001) and fTc (r=0.45, P<0.001) with DEQ levels. DEQ levels were significantly higher in women with PCOS compared to controls (P<0.05). Increased levels (95percentile of serum levels in control women) of T, fTc, A and DEQ were noted in 73, 71, 69 and 82% in women with PCOS, respectively. A total of 98% of the subjects with the highest quartile of DEQ levels had PCOS. The optimal DEQ cutoff value for predicting PCOS was 151.9 pg/l (96.0% sensitivity, 87.0% specificity) and the area under the ROC curve was 0.97 (95% confidence interval, 0.94–0.99). The DEQ levels were correlated with ovarian volume (r=0.51, P<0.001) and ovarian follicle number (r=0.58, P<0.001), total cholesterol (r=0.21, P=0.004), LDL cholesterol (r=0.16, P=0.022), fasting plasma insulin (r=0.31, P=0.002), post-load 2-h plasma insulin (r=0.21, P=0.034). DEQ levels may be a good indicator of hyperandrogenemia in women. We also confirm that measurement of DEQ levels in serum can be useful in making a diagnosis of PCOS.