Comparison of steroidogenic pathways among normoandrogenic and hyperandrogenic polycystic ovary syndrome patients and normal cycling women

Abstract

Aim To compare the corticosteroidogenic enzyme activities between normal cycling non‐polycystic ovary syndrome (PCOS), and normoandrogenic PCOS (NA‐PCOS) and hyperandrogenic PCOS (HA‐PCOS) patients. Methods This cohort study was conducted at Julio Muller University Hospital and Tropical Institute of Reproductive Medicine and Menopause, and enrolled 114 non‐PCOS women and 355 PCOS patients. The steroidogenic enzyme activities were measured using the serum steroid product/precursor molar ratio. Results In the Δ5 pathway the 17,20 lyase activity was equally low in the NA‐PCOS and HA‐PCOS women compared with the non‐PCOS women (P < 0.01 and P < 0.001, respectively). In the Δ4 pathway, the 17,20 lyase activity was higher only in the HA‐PCOS group (P < 0.001). The 17‐hydroxylase activity was the same in PCOS and non‐PCOS subjects (P > 0.05). The 3β‐hydroxysteroid dehydrogenase II (3β‐HSDII) activity was higher in the conversion of dehydroepiandrosterone into androstenedione in the HA‐PCOS than in the NA‐PCOS (P < 0.05) and the non‐PCOS patients (P < 0.01). The aromatase activity was lower in the HA‐PCOS than in the NA‐PCOS (P < 0.05) patients and non‐PCOS subjects (P < 0.01). In HA‐PCOS subjects, the 17,20 lyase activity was related to insulin, estradiol, total testosterone concentrations and free androgen index in the Δ5 pathway. 3β‐HSDII showed weak correlation with estradiol in the HA‐PCOS group. Anthropometric parameters had little impact, if any, on the steroidogenic enzyme activities. Conclusion The NA‐PCOS and HA‐PCOS patients demonstrated different enzyme activities, and the results provided new directions for future studies including PCOS patients with different phenotypes.

Relationship of Biological Markers of Body Fat Distribution and Corticosteroidogenic Enzyme Activities in Women with Polycystic Ovary Syndrome

“…In non- PCOS controls, 17,20 lyase activity was not influenced by any anthropometric parameter in the current study. In HA-PCOS, women the increased 17,20 lyase activity in the Δ4 pathway corroborates previously in vitro and in vivo studies [35]. The positive correlations between 17,20 lyase (Δ4 pathway) activity with adipose tissue in NA-PCOS and HA-PCOS support a previous observation [34] and suggest that an undefined adipocyte marker activates this enzyme in this pathway.…”

“…NA-PCOS, HA-PCOS and normal cycling women were compared to assess whether they present differences in the corticosteroidogenic enzyme activities among them. According to several robust publications, biochemical hyperandrogenemic PCOS may be defined by the presence of one or more of the following biochemical parameters: T ≥ 2.1 nmol/l, free T ≥ 0.027 pmol/l, DHEA ≥ 6.7 μmol/l, A4 ≥ 8.6 nmol/l, and free androgen index (FAI) ≥ 6 [22][23][24][25]. Patients who had used sex steroids or insulin sensitizing drugs over the last six months or who did not fulfill the Rotterdam criteria were excluded.…”

Adipose Tissue is a Potential Source of Hyperandrogenism in Obese Female Rats

“…This is frequently associated with insulin resistance and cardiometabolic risk factors from early ages . An excess of androgen production is thought to be a pivotal pathogenic mechanism of PCOS . Insulin resistance and hyperinsulinism enhance ovarian and adrenal androgen secretion in women with obesity .…”

Subclinical Hypothyroidism Impact on the Characteristics of Patients with Polycystic Ovary Syndrome. A Meta-Analysis of Observational Studies

“…Hormonally, it can present elevated luteinizing hormone (LH) levels with normal or slightly decreased levels of follicle-stimulating hormone, hyperandrogenemia, hyperinsulinemia, and normal levels of cortisol (F), prolactin (PRL), thyroid-stimulating hormone (TSH), thyroxine (T4), and free thyroxin (FT4) [1]. Low levels of sex hormone binding-globulin (SHBG) may represent a hyperinsulinemic status.…”