Endocrine Abstracts

Background of study

PCOS is a heterogeneous disease characterized by endocrine, metabolic and reproductive disorders. PCOS plays an essential role among the causes of chronic anovulation, menstrual irregularities, hirsutism and anovulatory infertility. Diagnostic problems appear to be extremely urgent due to the wide range of clinical and laboratory manifestations. The study of urine steroid profile by gas chromatography-mass spectrometry will improve the assessment of steroid metabolomics, and will allow for the increase in the percentage of PCOS detection, particularly at the early stages of the disease, to provide prompt treatment.

Aims of study

To study the metabolomics of androgens, progestinsand glucocorticoids by gas chromatography-mass spectrometry in obese and non-obese women with polycystic ovary syndrome

Study design, materials, and methods

53 women of reproductive age with PCOS were examined. The first group included 30 women aged 22 to 29 years with normal body weight. The second group comprised 23 obese patients aged 25 to 33 years with an average body mass index (BMI). Steroid urine profiles (SPM) were studied by means of gas chromatography-mass spectrometry (GC-MS) with optimization of the sample preparation schedule. 69 steroids were identify by this method.

Results

In women with PCOS and obesity, urinary excretion of androsterone and dehydroepiandrosterone metabolites (16-oхо-androstenediol and androstenediol-17β) was increased. In patients of normal body weight with PCOS an increase in urinary excretion of androstenedione metabolites, dehydroepiandrosterone and its metabolites, 17-hydroxypregnanolone and pregnanolone, 5-en-pregnenes was revealed. In addition, the reduction in the ratio of cortisoltetrahydro derivatives combined with cortisone to 11-oxo-pregnanthriol, pregnanthriol and 17-hydroxypregnanolone was detected, which is associated with21-hydroxylase enzyme and 3β-hydroxysteroid dehydrogenasedeficiency, which is indicative of hyperandrogenism mixed genesis. An increase in urinary excretion of 5α-tetrahydrocortisone and cortolones, the signs of decreased activity of 11β-hydroxysteroid dehydrogenase type 1 were found out in PCOS patients regardless of body mass index, which indicates functional hypercortisolism.

Conclusion

Determining simultaneously the number of androstenedione and DHEA metabolites, progestins, α- and β-glucocorticoid metabolites in the study of SPM by GC-MS method suggests new opportunities for the diagnosis and differential diagnosis of various presentations in PCOS.