Assessment of anogenital distance as a diagnostic tool in polycystic ovary syndrome

Hernández-Peñalver, Ana I.; Sánchez-Ferrer, María Luisa; Mendiola, Jaime; Adoamnei, Evdochia; Prieto-Sánchez, María T; Corbalán-Biyang, Shiana; Carmona-Barnosi, Ana; Nieto, Anı́bal; Torres-Cantero, Alberto M.

doi:10.1016/j.rbmo.2018.08.020

Cited by 27 publications

(20 citation statements)

References 48 publications

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Section: Discussionsupporting

confidence: 62%

“…Our finding of comparable AGD in girls born of mothers with PCOS and controls is interesting in the context of two recent case-control studies of AGD in adult women with PCOS (Sanchez-Ferrer et al, 2017;Wu et al, 2017;Hernandez-Penalver et al, 2018). These studies were conducted in 156 Chinese (Wu et al, 2017) and 126 Mediterranean (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018) women with PCOS compared to controls. Women with PCOS were relatively lean [(mean BMI 22.1 kg/m 2 (Wu et al, 2017) and 24.1 kg/m 2 (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018)] in both study cohorts, and included patients who were matched to controls according to BMI in the study by Wu (Wu et al, 2017), whereas controls were on average 5 kg lighter than women with PCOS in the study by Sanchez (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018).…”

Section: Discussionsupporting

confidence: 62%

“…These studies were conducted in 156 Chinese (Wu et al, 2017) and 126 Mediterranean (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018) women with PCOS compared to controls. Women with PCOS were relatively lean [(mean BMI 22.1 kg/m 2 (Wu et al, 2017) and 24.1 kg/m 2 (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018)] in both study cohorts, and included patients who were matched to controls according to BMI in the study by Wu (Wu et al, 2017), whereas controls were on average 5 kg lighter than women with PCOS in the study by Sanchez (Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018). Longer AGDac and AGDaf in women with PCOS versus controls were reported in both studies (Wu et al, 2017;Sanchez-Ferrer et al, 2017;Hernandez-Penalver et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we are not aware of studies that measured maternal testosterone levels and offspring AGD in healthy pregnant women or in pregnant women grouped according to diagnosis of PCOS. Few studies have been performed in adult study populations of women with PCOS (Sanchez-Ferrer et al, 2017;Wu et al, 2017;Hernandez-Penalver et al, 2018). Two case-control studies (presented in three papers) found that adult women with PCOS had a longer AGD than controls (Sanchez-Ferrer et al, 2017;Wu et al, 2017;Hernandez-Penalver et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

et al. 2019

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STUDY QUESTION Are higher testosterone levels during pregnancy in women with polycystic ovary syndrome (PCOS) associated with longer offspring anogenital distance (AGD)? SUMMARY ANSWER AGD was similar in 3-month-old children born of mothers with PCOS compared to controls. WHAT IS KNOWN ALREADY AGD is considered a marker of prenatal androgenization. STUDY DESIGN, SIZE, DURATION Maternal testosterone levels were measured by mass spectrometry at Gestational Week 28 in 1127 women. Maternal diagnosis of PCOS before pregnancy was defined according to Rotterdam criteria. Offspring measures included AGD from anus to posterior fourchette (AGDaf) and clitoris (AGDac) in girls and to scrotum (AGDas) and penis (AGDap) and penile width in boys and body composition (weight and BMI SD scores) at age 3 months. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was part of the prospective study, Odense Child Cohort (OCC), and included mothers with PCOS (n = 139) and controls (n = 1422). The control population included women with regular menstrual cycles (<35 days) before conception and no signs of androgen excess (hirsutism and/or acne). MAIN RESULTS AND THE ROLE OF CHANCE AGD measures were comparable in offspring of women with PCOS compared to controls (all P > 0.2) despite significantly higher maternal levels of total testosterone (mean: 2.4 versus 2.0 nmol/l) and free testosterone (mean: 0.005 versus 0.004 nmol/l) in women with PCOS versus controls (both P < 0.001). In women with PCOS, maternal testosterone was an independent positive predictor of offspring AGDas and AGDap in boys. Maternal testosterone levels did not predict AGD in girls born of mothers with PCOS or in boys or girls born of women in the control group. LIMITATIONS, REASONS FOR CAUTION The diagnosis of PCOS was based on retrospective information and questionnaires during pregnancy. Women participating in OCC were more ethnically homogenous, leaner, more educated and less likely to smoke compared to the background population. Our study findings, therefore, need to be reproduced in prospective study cohorts with PCOS, in more obese study populations and in women of other ethnicities. WIDER IMPLICATIONS OF THE FINDINGS Our finding of the same AGD in girls born of mothers with PCOS compared to controls expands previous results of studies reporting longer AGD in adult women with PCOS. Our results suggest that longer AGD in adult women with PCOS could be the result of increased testosterone levels in puberty, perhaps in combination with weight gain. STUDY FUNDING/COMPETING INTEREST(S) Financial grants for the study were provided by the Danish Foundation for Scientific Innovation and Technology (09-067180), Ronald McDonald Children Foundation, Odense University Hospital, the Region of Southern Denmark, the Municipality of Odense, the Mental Health Service of the Region of Southern Denmark, The Danish Council for Strategic Research, Program Commission on Health, Food and Welfare (2101-08-0058), Odense Patient data Explorative Network, Novo Nordisk Foundation (grant no. NNF15OC00017734), the Danish Council for Independent Research and the Foundation for research collaboration between Rigshospitalet and Odense University Hospital and the Health Foundation (Helsefonden). There is no conflict of interest of any author that could be perceived as prejudicing the impartiality of the research reported.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

et al. 2019

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“…Recently, several studies demonstrated that AGD in adult patients with the polycystic ovarian syndrome (PCOS) was longer than control, implying that extreme prenatal androgen exposure contributes to PCOS [15,19,20]. The PCOS is a hyperandrogenic, oligomenorrhea/amenorrhea, fertility problems and metabolic disorder found in 6-7% of reproductive-aged women [21].…”

Section: Discussionmentioning

confidence: 99%

Premenstrual Dysphoric Disorder is Associated with the Longer Length from Clitoris to Urethra

Jin

Zhu

2020

Preprint

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Background: Premenstrual dysphoric disorder (PMDD) is a common, recently recognized, psychiatric condition among reproductive women, reflecting abnormal responsivity to ovarian steroids. Moreover, the organizational effects of prenatal sex hormones during the embryonic environment that may determine individual sensitivity to fluctuation of sex hormones, have got attentions, but there have been considerably less of researches on this topic. The aim of this research was to investigate the possible role of prenatal androgen in the PMDD.Methods: Anogenital distance (AGD), the distance between a woman’s clitoris and her urethral meatus (CUMD), left and right 2D:4D ratios were measured in 77 subjects (25 patients with PMDD), as these anthropometric indicators are considered to indirectly reflect prenatal androgen exposures in utero. Results: Patients with PMDD had a longer CUMD than controls (25.03±4.73 vs 22.07 ± 4.30, P=0.008), while there were no significant difference between PMDD group and control group in the AGD and right and left 2D:4D ratios.Conclusion: Atypical high prenatal androgen exposure might predispose individuals to be susceptible to PMDD.

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Association between prenatal exposure to perfluoroalkyl substances and anogenital distance in female neonates

Yang

et al. 2022

Ecotoxicology and Environmental Safety

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Assessment of anogenital distance as a diagnostic tool in polycystic ovary syndrome

Cited by 27 publications

References 48 publications

Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

Anogenital distance in children born of mothers with polycystic ovary syndrome: the Odense Child Cohort

Premenstrual Dysphoric Disorder is Associated with the Longer Length from Clitoris to Urethra

Association between prenatal exposure to perfluoroalkyl substances and anogenital distance in female neonates

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