Endocrine Abstracts

Objective: Androsterone glucuronide (ADTG) concentrations have been suggested as a more reliable marker of the effects of androgens at the target tissue level and they are significantly elevated in hirsute compared to non-hirsute women with PCOS. This study compared the different precursors of testosterone, including dehydroepiandrosterone sulphate (DHEAS), ADTG and androstenedione in non-obese compared to obese women with PCOS, and in normal subjects and their implications on cardiovascular risk.

Design and Method: Eleven non-obese and 14 obese women with PCOS were recruited and compared to 11 control women without PCOS. DHEAS, ADTG, androstenedione and total testosterone were analysed using tandem mass spectrometry and comparison made between the three groups.

Results: ADTG and androstendione levels did not differ between non-obese and obese PCOS but were significantly higher than for controls (P<0.01). However, the ADTG to DHEAS ratio was significantly elevated 39±6 (P<0.01) in obese PCOS in comparison to non obese PCOS and controls (28±5 and 29±4, respectively). Both non-obese and obese PCOS were equally hyperandrogenic as measured by total testosterone (P=0.74), but the FAI and insulin resistance (HOMA-IR) was significantly higher in obese PCOS (both P<0.01). DHEAS was significantly higher in the non-obese versus obese PCOS (P<0.02). All androgen parameters were significantly lower and SHBG significantly higher in normal subjects compared to those with obese and non-obese PCOS.

Conclusion: ADTG:DHEAS ratio was significantly elevated in obese PCOS compared to non-obese PCOS and controls suggesting that this may be a novel biomarker. It is likely that this raised ratio may be due to higher hepatic 5α reductase activity increasing the conversion of its precursors to ADTG likely driven by increased insulin resistance seen in obese women with PCOS.