Endocrine Abstracts

Context: Polycystic ovary syndrome (PCOS) is a very common endocrinopathy affecting approximately 6–18% of women of reproductive age. It is also the most common cause of infertility due to anovulation. PCOS is characterized by menstrual disorders, polycystic or enlarged ovaries on ultrasound, but hyperandrogenism is the central feature of PCOS. Assessing of serum testosterone level (T) or free T is recommended by the guidelines in the diagnosis of PCOS. Diagnostic value of androstenedione is undetermined. Dehydroepiandrosterone sulfate (DHEA-S), an androgen nearly exclusively produced by the adrenals, is increased in many women suffering from PCOS, however its measurement is often omitted.

Aim: The aims of the study were:

1. to assess the frequency of increased level of testosterone (T), androstenedione (A) and DHEA-S in PCOS patients;

2. to examine the level of androgen suppression in low-dose (1 mg) night dexamethasone suppression test (LDDST) in PCOS patients.

Subjects and Methods: We analysed data of 195 young (median age 24.76 years) women, who were the patients of our Endocrinology Department, in whom PCOS was recognized with AES Criteria (2006) and T, A and DHEA-S level were measured. In n=104 patients LDDST was performed.

Results: 1. Increased T was found in n=61 (31%) subjects and in n=15 (8%) it was the only one elevated androgen (A and DHEA-S were within normal range).

2. Increased A was found in n=97 (50%) subjects and in n=35 (18%) it was the only one elevated androgen (T and DHEA-S were within normal range).

3. Increased DHEA-S was found in n=77 (39%) subjects and in n=19 (10%) it was the only one elevated androgen (T and A were within normal range).

4. LDDST revealed 33% decrease in the concentration of T, 45% decrease in the concentration of A and 41% decrease in the concentration of DHEA-S.

Conclusions: 1. The value of A and DHEA-S measurement in the diagnostic process of hyperandrogenism in PCOS is underestimated.

2. In case of women with PCOS, a significant part of A and DHEA-S is produced by ovaries.

3. The measurement of A and DHEA-S concentrations is essential and useful in the diagnosis of hyperandrogenism in PCOS.