The frequency of late-onset 21-hydroxylase and 11 beta-hydroxylase deficiency in women with polycystic ovary syndrome

1997 ◽  
pp. 670-674 ◽  
Author(s):  
Y Sahin ◽  
F Kelestimur
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Late Onset ◽  
Polycystic Ovary ◽  
Serum Testosterone ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Acth Stimulation ◽  
Hydroxylase Deficiency ◽  
Ovary Syndrome ◽  
Biochemical Features

OBJECTIVE: To determine the frequency of late-onset adrenal hyperplasia (LOCAH) due to 21-hydroxylase (21-OH) and 11 beta-hydroxylase (11 beta-OH) deficiency in women with clinical and biochemical features of polycystic ovary syndrome (PCOS). DESIGN: Eighty-three consecutively selected women with PCOS and eighteen normal women were included in the study. METHODS: Ultrasound, clinical and hormonal parameters were used to define PCOS. Basal FSH, LH, testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG) and cortisol levels were measured. Serum 17-hydroxyprogesterone (17-OHP) and 11-deoxycortisol (11-DOC) levels were also measured before, 30 and 60 min after a single bolus injection of 0.25 mg ACTH (1-24) at 0900 h during the mid-follicular phase of the cycle. ACTH-stimulated 17-OHP levels > 30 nmol/l were considered as the criteria of 21-OH deficiency. The diagnosis 11 beta-OH deficiency was made if the adrenal 11-DOC response to ACTH stimulation exceeded threefold the 95th percentile of controls. RESULTS: Basal serum testosterone, free testosterone, androstenedione, DHEA-S, cortisol and 11-DOC levels were significantly higher in PCOS than in control subjects. ACTH-stimulated 17-OHP (P < 0.05) and 11-DOC (P < 0.0005) levels were found to be significantly higher in patients with PCOS than in controls. Seven (8.4%) patients had an 11-DOC response to ACTH higher than threefold the 95th percentile of controls, while no patients showed evidence of 21-OH deficiency. CONCLUSIONS: We have found that 8.4% of the women with clinical and biochemical features of PCOS could be presumed to have 11 beta-OH deficiency. No patients among the women with PCOS showed evidence of 21-OH deficiency. 11 beta-OH deficiency is unexpectedly more common than 21-OH deficiency in women with PCOS.

scholarly journals Polycystic ovary syndrome: clinical and laboratory evaluation

1996 ◽  
Vol 114 (4) ◽  
pp. 1222-1225 ◽  
Author(s):  
Marcos Yorghi Khoury ◽  
Edmund Chada Baracat ◽  
Dolores Perovano Pardini ◽  
Mauro Abi Haidar ◽  
Eduardo Leme Alves da Motta ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Laboratory Tests ◽  
Late Onset ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Dehydroepiandrosterone Sulfate ◽  
Laboratory Evaluation ◽  
Clinical Feature ◽  
Age At Menarche ◽  
Ovary Syndrome

OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO). PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI); and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free testosterone, and dehydroepiandrosterone sulfate were taken. RESULTS: All patients presented either oligomenorrhea (31 percent), periods of secondary amenorrhea (9 percent), or both alterations (60 percent). The majority of the patients were infertile (75.6 percent). The LH/FSH ratio was higher than 2:1 in 55 percent of the patients and higher than 3:1 in 26.2 percent. The ultrasonographic aspect of the ovaries was considered to be normal in 31 percent. CONCLUSION: The main clinical feature of the PCO is the irregularity of menses since menarche, and that the laboratory tests would be important to exclude other disorders such as hyperprolactinemia or hyperandrogenemia caused by late-onset congenital adrenal hyperplasia.

Increased urinary free cortisol and decreased serum corticosteroid-binding globulin in polycystic ovary syndrome

1991 ◽  
Vol 125 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Cecilia Invitti ◽  
Francesca Pecori Giraldi ◽  
Antonella Dubini ◽  
Martina De Martin ◽  
Francesco Cavagnini
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Urinary Free Cortisol ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Ovary Syndrome ◽  
Free Cortisol ◽  
Corticosteroid Binding Globulin

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.

Association between Biomarkers of Low-grade Inflammation and Sex Hormones in Women with Polycystic Ovary Syndrome

2019 ◽  
Vol 128 (11) ◽  
pp. 723-730 ◽  
Author(s):  
Erifili Hatziagelaki ◽  
Vasilios Pergialiotis ◽  
Julia M. Kannenberg ◽  
Eftihios Trakakis ◽  
Anastasia Tsiavou ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Sex Hormones ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Endocrine Function ◽  
Sex Hormone Binding Globulin ◽  
Low Grade ◽  
Ovary Syndrome ◽  
Reactive Protein ◽  
Low Grade Inflammation

Abstract Objective Women with polycystic ovary syndrome (PCOS) have higher circulating levels of C-reactive protein, but the relationship between inflammation and endocrine function in PCOS remains poorly understood. Thus, this study aimed to investigate the association between low-grade inflammation and sex hormones in women with PCOS. Design and Patients A comprehensive panel of biomarkers of inflammation was measured in serum of 63 women with PCOS using proximity extension assay technology. Associations of 65 biomarkers with sex hormones were assessed without and with adjustment for age and body mass index (BMI). Results In the unadjusted analysis, 20 biomarkers were positively correlated with 17-OH-progesterone (17-OH-P), 14 with prolactin and 6 with free testosterone, whereas inverse associations were found for 16 biomarkers with sex hormone-binding globulin (SHBG), 6 with luteinizing hormone (LH) and 6 with estrogen (all p<0.05). Among the positive associations, correlations were mainly found for five chemokines (CXCL11, CCL4, MCP-4/CCL13, CXCL5, CXCL6) and for VEGF-A, LAP-TGFβ1, TNFSF14 and MMP-1. Inverse associations with sex hormones were mainly present for two chemokines (CXCL1, MCP-2/CCL8), CDCP1, CST5 and CSF-1. Adjustment for age and BMI reduced the number of biomarker associations for SHBG and estrogen, but had hardly any impact on associations with 17-OH-P, prolactin, free testosterone and LH. Conclusion Women with PCOS feature BMI-independent associations between biomarkers of inflammation and certain sex steroid and hypophyseal hormones. Most of these inflammation-related biomarkers were chemokines, which may be relevant as potential mediators of the increased cardiometabolic risk of women with PCOS.

scholarly journals Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome

1998 ◽  
pp. 269-274 ◽  
Author(s):  
E Diamanti-Kandarakis ◽  
C Kouli ◽  
T Tsianateli ◽  
A Bergiele
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Therapeutic Effects ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Before And After ◽  
Ovarian Hyperandrogenism

Evidence suggests that insulin resistance and hyperinsulinaemia are associated with ovarian hyperandrogenism and menstrual irregularities in polycystic ovary syndrome (PCOS). Sixteen obese women with PCOS on a weight-maintaining diet were studied before and after 6 months of therapy with the insulin-sensitizing antidiabetic agent metformin at a dose of 1700 mg per day. Compared with baseline values, glucose utilization was markedly enhanced at 6 months using the two-step euglycaemic-hyperinsulinaemic clamp to measure changes in insulin sensitivity (2.56 +/- 0.32 vs 4.68 +/- 0.49 mg/kg per min, P = 0.0001, when 40 mU insulin/m2 per min was infused, and 6.48 +/- 0.58 vs 9.84 +/- 0.72 mg/kg per min, P = 0.0002, when 400 mU insulin insulin/m2 per min was infused). The improvement in insulin action was accompanied by significant increases in the levels of sex hormone-binding globulin (24.5 +/- 7.2 vs 39.8 +/- 16.2 nmol/l, P = 0.003) and decreases in free testosterone (12.8 +/- 5.8 vs 9.0 +/- 3.0 pmol/l, P = 0.03) and androstenedione (12.9 +/- 5.6 vs 7.3 +/- 1.7 nmol/l, P = 0.003). No significant changes were recorded in body weight. Seven subjects resumed normal menstruation and two cases of spontaneous pregnancy occurred during treatment. Metformin was well tolerated except for one case of flatulence. These results confirm that metformin treatment can lead to improvements in insulin resistance and ovarian hyperandrogenism.

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

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.

scholarly journals Ovarian-adrenal cross-talk in polycystic ovary syndrome: evidence from wedge resection

2000 ◽  
pp. 383-388 ◽  
Author(s):  
XK Wu ◽  
SY Zhou ◽  
K Sallinen ◽  
P Pollanen ◽  
R Erkkola
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Wedge Resection ◽  
Sex Hormone Binding Globulin ◽  
Acth Stimulation ◽  
Adrenal Androgen ◽  
Ovary Syndrome ◽  
Glucose Ratio ◽  
Clomiphene Resistance ◽  
17 Hydroxyprogesterone

OBJECTIVE: To determine whether the ovary influences adrenal androgen secretion in women with polycystic ovary syndrome (PCOS). DESIGN: Six PCOS-affected patients with clomiphene resistance and gonadotrophin hyperresponsivity, and six controls with regular ovulatory cycles, matched for age and body mass index. METHODS: Bilateral ovarian wedge resection was performed to induce ovulation surgically for these refractory women with PCOS. The adrenal androgen secretions were evaluated in PCOS patients before and again 6 months after this surgery, and in the controls, using an ACTH stimulation test (0.25mg synthetic ACTH(1-24)). RESULTS: Biochemically, basal levels and the maximum net increases (Delta) of 17-hydroxyprogesterone (17-OHP) and androstenedione, Delta17-OHP/Delta progesterone and Delta androstenedione/Delta17-OHP ratios in response to exogenous ACTH were significantly higher in PCOS patients before operation than those of controls. This purely ovarian surgery in women with PCOS was found to significantly reduce their basal androstenedione, testosterone and LH levels, insulin/glucose ratio, and post-corticotrophic Delta17-OHP, Delta androstenedione, Delta17-OHP/Delta progesterone and Delta androstenedione/Delta17-OHP, without obvious changes in FSH, oestradiol, sex hormone-binding globulin, Delta dehydroepiandrosterone, Delta dehydroepiandrosterone sulphate, Delta aldosterone and Delta cortisol values. CONCLUSIONS: Ovarian hyperandrogenicity from polycystic ovary may contribute to the enhanced adrenal P450c17alpha activity and subsequent Delta(4) androgen reserve revealed by the pharmacological corticotrophin stimulation in our special PCOS cases.

scholarly journals Effect of glabridinon on insulin resistance, C-reactive protein and endothelial function in young women with polycystic ovary syndrome

2015 ◽  
Vol 10 (3) ◽  
pp. 681 ◽  
Author(s):  
Bing-Guo Luan ◽  
Cai-Xia Sun
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Serum Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Fasting Insulin ◽  
C Reactive Protein ◽  
Ovary Syndrome ◽  
Menstrual Cycles ◽  
Reactive Protein

<p class="Abstract">In the present study 32 women with polycystic ovary syndrome were treated with glabridin (10 µM ) daily for 12 months. The results revealed a significant reduction in serum testosterone from 95.3 ± 23.6 to 49.8 ± 12.7 ng/dL and fasting insulin concentrations from 12.3 ± 5.2 to 8.11 ± 3.42 U/mL after glabridin treatment. It also leads to a marked improvement in insulin resistance indices and reduction in hirsutism score from 12.8 ± 3.2 to 7.0 ± 3.5. More interestingly, all the women reverted to regular menstrual cycles. The sex hormone-binding globulin level increased significantly from 23.1 ± 5.6 to 52.5 ± 15.8 nmol/L after glabridin treatment. The levels of serum hsCRP decreased from 0.32 ± 0.08 to 0.06 ± 0.01 mg/dL and that of endothelium-dependent vascular responses from 17.2 ± 4.3 to 8.8 ± 2.4% after glabridin treatment. Therefore, glabridin acts as a potent candidate for the improve-ment of insulin sensitivity and androgen production.</p><p> </p>

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