The relationships of sex hormone‐binding globulin, total testosterone, androstenedione and free testosterone with metabolic and reproductive features of polycystic ovary syndrome

Abstract. The adrenal participation in the pathogenesis of polycystic ovary syndrome is still under debate. In order to reappraise androgen and glucocorticoid secretion in this disease, we measured serum androstenedione, dehydroepiandrosterone-sulphate, total and free testosterone, sex hormone-binding globulin, LH, FSH, PRL, cortisol, corticosteroid-binding globulin, and urinary free cortisol in 45 women with polycystic ovary syndrome and 27 controls, subdivided in obese and normal-weight subjects. Androstenedione, total and free testosterone were significantly increased, whereas sex hormone-binding globulin tended to be reduced in patients with polycystic ovary syndrome compared with controls, reaching a significant difference between obese patients and matched controls. Free testosterone and sex hormone-binding globulin were significantly increased and reduced, respectively, in obese compared with normal-weight patients. Urinary free cortisol and serum corticosteroid-binding globulin were significantly increased (p<0.001) and decreased (p<0.005), respectively. Urinary free cortisol exceeded the upper limit of the normal range in 50% of our patients. No appreciable differences were found in PRL and cortisol levels. Besides confirming a hyperandrogenic state, our findings point to an overactivity of the hypothalamic-pituitary-adrenal axis with subsequent diminution of corticosteroid-binding globulin in polycystic ovary syndrome. They also indicate that urinary free cortisol is not a reliable index in differentiating polycystic ovary syndrome from Cushing's disease.

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The synergistic effect of sex hormone-binding globulin and aromatase genes on polycystic ovary syndrome phenotype.

Acta Endocrinologica ◽

10.1530/eje-07-0905 ◽

2008 ◽

Vol 158 (6) ◽

pp. 861-865 ◽

Cited By ~ 29

Author(s):

Nectaria Xita ◽

Ioannis Georgiou ◽

Leandros Lazaros ◽

Vasiliki Psofaki ◽

George Kolios ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Sex Hormone ◽

The Body ◽

Reproductive Age ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Aromatase Activity ◽

Hormone Binding ◽

Ovary Syndrome

ObjectiveExperimental evidence suggests that fetal exposure to androgen excess may program the development of polycystic ovary syndrome (PCOS) in utero. The aim of this study was to examine whether the sex hormone binding globulin (SHBG)(TAAAA)n and the cytochrome P450, family 19 (CYP19)(TTTA)n polymorphisms, known to influence sex hormone-binding globulin (SHBG) levels and aromatase activity respectively, play a synergistic role in the development of PCOS.Design and methodsWe studied 180 women with PCOS and 160 healthy women of reproductive age. The body mass index (BMI) was recorded and the hormonal profile determined from the third to fifth day of menstrual cycle. DNA was extracted from blood leucocytes and the SHBG(TAAAA)n and CYP19(TTTA)n polymorphisms were genotyped.ResultsGenotype analysis revealed 6 SHBG(TAAAA)n alleles with 6–11 repeats and 6 CYP19(TTTA)n alleles with 7–12 repeats. Women were subdivided into four groups: those with short SHBG (≤8 TAAAA repeats) and CYP19 alleles (≤9 TTTA repeats), those with short SHBG–long CYP19 alleles, those with long SHBG–short CYP19 alleles, and those with long SHBG and CYP19 alleles. Women with PCOS tended to have at greater frequency, long SHBG–short CYP19 alleles compared with controls (57.3 vs 42.4%, P=0.07). Importantly, PCOS women with long SHBG–short CYP19 alleles had the lowest SHBG levels (P=0.02) and the highest total testosterone (P=0.008), free androgen index (P=0.002), DHEAS (P=0.02), and testosterone/estradiol ratio (P=0.03), compared with those with other genotypes. This association was independent of age, BMI, and insulin resistance indexes.ConclusionWe speculate that the SHBG and CYP19 genes may have a synergistic role in the developmental programming of PCOS, by affecting androgen bioavailability and aromatization respectively.

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The Associations between Sex Hormones and Lipid Profiles in Serum of Women with Different Phenotypes of Polycystic Ovary Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10173941 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3941

Author(s):

Anna Bizoń ◽

Grzegorz Franik ◽

Justyna Niepsuj ◽

Marta Czwojdzińska ◽

Marcin Leśniewski ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Lipid Profile ◽

Sex Hormones ◽

Polycystic Ovary ◽

Free Testosterone ◽

Lipid Profiles ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Ovary Syndrome

We aimed to evaluate the relationship between selected serum sex hormones and lipid profiles in a group of women with polycystic ovary syndrome (PCOS) dividing according to four phenotypes, value of body mass index (BMI), and presence of hyperlipidemia. The study included 606 Caucasian women. Lipids and selected hormones were estimated using commercially available procedures during hospitalization in 2017. Phenotype of PCOS, BMI value, and hyperlipidemia were significant factors that influenced androgen hormone concentrations, such as total and free testosterone and androstenedione as well as the value of free androgen index (FAI). Moreover, significant changes in concentrations of dehydroepiandrosterone sulphate and sex hormone binding globulin (SHBG) were found between those groups. Higher quartiles of triglyceride concentrations increased the odds ratio of decreased concentrations of SHBG or increased values of FAI, while an adverse relation was found in case of HDL-C. The concentration of estradiol in the blood of women with PCOS was not associated with lipid profile parameters in any investigated groups. Probably, irregularities in sex hormone concentrations during PCOS is not directly associated with lipid profile parameters but could be reflective of the concentration of SHBG or the ratio of SHBG and total testosterone and their association with lipids.

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A Direct Effect of Hyperinsulinemia on Serum Sex Hormone-Binding Globulin Levels in Obese Women with the Polycystic Ovary Syndrome*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem-72-1-83 ◽

1991 ◽

Vol 72 (1) ◽

pp. 83-89 ◽

Cited By ~ 443

Author(s):

JOHN E. NESTLER ◽

LINDA P. POWERS ◽

DENNIS W. MATT ◽

KENNETH A. STEINGOLD ◽

STEPHEN R. PLYMATE ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Direct Effect ◽

Polycystic Ovary ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Obese Women ◽

Hormone Binding ◽

Ovary Syndrome

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The Correlation of Serum Total Testosterone, Sex Hormone Binding Globulin and Free Androgen Index with Athens Insomnia Scale Score in Polycystic Ovary Syndrome

The Indonesian Biomedical Journal ◽

10.18585/inabj.v10i1.324 ◽

2018 ◽

Vol 10 (1) ◽

pp. 46

Author(s):

Hartanto Bayuaji ◽

Heda Melinda Nazaruddin Nataprawira ◽

Herri Suhari Sastramihardja

Keyword(s):

Polycystic Ovary Syndrome ◽

Sleep Disturbance ◽

Testosterone Level ◽

Polycystic Ovary ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Hormone Binding ◽

Ovary Syndrome ◽

Free Androgen Index ◽

Athens Insomnia Scale

BACKGROUND: Polycystic ovary syndrome (PCOS), a common reproductive endocrinologic disorder in woman, was considered to be related to sleep disturbance. This study is aimed to analyze the correlation between excess androgen markers and Athens Insomnia Scale (AIS) in PCOS.METHODS: This observational, cross-sectional study of PCOS was conducted to 31 subjects to evaluate the correlation between serum total testosterone, sex hormone binding globulin (SHBG) and free androgen index with the incidence of sleep disturbance using AIS. Sleep disturbance was present if the score ≥6. The correlation between excess androgen markers and sleep disturbance was analyzed using Pearson’s coefficient of correlation or Spearman’s rho test. Correlation coefficient more than 0.5 with p<0.05 was considered significant.RESULTS: Out of 31 PCOS subjects aged 20-40 years, 39% subjects had AIS score ≥6. Mean serum testosterone in AIS score >6 group was higher than AIS score <6 group but not statistically significant (46.68 vs. 28.49 ng/mL, p>0.05). No significant correlation was found between serum total testosterone, SHBG and free androgen index with AIS score. After adjusting for AIS score, there was the moderate positive correlation between serum total testosterone level although not statistically significant (r=0.54, p=0.07).CONCLUSION: The serum total testosterone level might influence the occurrence of sleep disturbance in PCOS.KEYWORDS: PCOS, androgen excess, testosterone, sleep disturbance, Athens Insomnia Scale

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