Endocrine Abstracts

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among premenopausal women affecting up to 20% of the population. Even though androgen excess is the main diagnostic criterion for PCOS, the evaluation of hyperandrogenemia relies on methods with low accuracy and mainly able to measure total androgen amounts. Liquid chromatography-tandem mass spectrometry (LC–MS/MS) allows high accuracy steroids measurement and if applied to saliva, it also allows the measurement of free or biovalable fractions. We performed seventeen-hours circadian salivary androgens analysis and serum steroids circadian profile in 9 classic PCOS (oligomenorrhea + hirsutism/high testosterone + polycystic ovary morphology) and 7 fertile controls. Subjects woke-up at 0700 h and collected saliva by direct spitting in fasting condition. At 0800 h subjects went to hospital for blood withdrawal, second saliva collection and anthropometric data recording. The blood collection was repeated at 1000 h and 1600 h. Saliva was collected every hour until 2300 h. Daily food intake and menstrual phase were standardized. Steroids were measured by validated LC–MS/MS methods and area under curve (AUCg) was computed. Compared to controls, PCOS girls were younger (P=0.023) and displayed higher BMI (P=0.017) and waist circumference (P=0.011). Both baseline levels and circulating hormones daily exposure were higher in PCOS: testosterone (P=0.001; P=0.006) androstenedione (P<0.001 for both) DHEA (P=0.004; P=0.001) and 17OHProgesterone (P<0.001 for both). Moreover, PCOS group showed higher estrone (P=0.002; P=0.006) and 17OHpregnenolone (P=0.013; P=0.001) levels compared to controls. No differences were found for serum cortisol, cortisone, corticosterone, 11-deoxycortisol, progesterone, estradiol and dihydrotestosterone. PCOS displayed higher salivary androgens both at basal levels and in daily exposure: testosterone (4.41±0.96 vs 13.5±6.9 pg/ml, P<0.001; 3314.9±1029.7 vs 8328.9±2984.7 AUCg, P<0.001) androstenedione (69.6±18.7 vs 162.3±49.9 pg/ml, P<0.001; 51829.7±14968.3 vs 125592.7±36501.2 AUCg, P<0.0001), DHEA (169.2±100.4 vs 349.1±152.1 pg/ml, P=0.007; 113272.3±47145.4 vs 185457.8±67046.8 AUCg, P=0.018) and 17OHProgesterone (10.5±4.9 vs. 25.1±10.2 pg/ml, P=0.010; below sensitivity limit vs 14643.0±2790.0 AUCg) compared to controls. PCOS subjects displayed high serum testosterone, androstenedione, DHEA, 17OHProgesterone, 17OHpregnenolone and estrone, both at baseline and in daily exposure. Increased serum androgens resulted in high salivary androgens too, showing the salivary androgens profiling as promising tool for non-invasive diagnostic work-up of PCOS patients.