Helpful diagnostic markers of steroidogenesis for defining hyperandrogenemia in hirsute women

Willenberg, Holger S.; Bahlo, M.; Schott, M.; Wertenbruch, Tina; Feldkamp, Joachim; Scherbaum, Werner A.

doi:10.1016/j.steroids.2007.08.009

Cited by 12 publications

(6 citation statements)

References 22 publications

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“…Anthropometric parameters were measured as previously described (8). Hyperandrogenism was defined as total T ≥ 2.4 nmol/L, A ≥ 8.7 nmol/L, DHEAS ≥ 6.7 nmol/L, and free androgen index (FAI) ≥ 7 (8,16). The FAI was estimated as the total T (nmol/L)/sex hormone-binding globulin (SHBG; nmol/L) x 100.…”

Section: Methodsmentioning

confidence: 99%

New insights into steroidogenesis in normo- and hyperandrogenic polycystic ovary syndrome patients

Gil-Junior¹,

Barbosa

Isaías³

et al. 2013

Arq Bras Endocrinol Metab

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Objective: This study sought to examine corticosteroidogenic enzyme activities in normo-and hyperandrogenic polycystic ovary syndrome (PCOS) patients. Subjects and methods: This cohort study included 81 patients with biochemical hyperandrogenism and 41 patients with normal androgen levels. Enzyme activities were assessed according to the serum steroid product/precursor ratios at baseline and after adrenal stimulation. Results: At baseline, in the delta 4 (Δ4) pathway, hyperandrogenic patients showed greater 17-hydroxylase and 17,20 lyase activities in converting progesterone (P4) into 17-hydroxyprogesterone (17-OHP4) and 17-hydroxypregnenolone (17-OHPE) into androstenedione (A) (p = 0.0005 and p = 0.047, respectively) compared to normoandrogenic patients. In the delta 5 (Δ5) pathway, the 17-hydroxylase and 17,20 lyase enzymes showed similar activities in both groups. Hyperandrogenic patients presented lower 21-hydroxylase, lower 11β-hydroxylase (p = 0.0001), and statistically significant increases in 3β-hydroxysteroid dehydrogenase II (3β-HSDII) activities (p < 0.0001). Following tetracosactrin stimulation, only the 17,20 lyase activity remained up--regulated in the Δ4 pathway (p < 0.0001). Conclusion: Hyperandrogenic patients had higher 17,20 lyase activity, both at baseline and after adrenal stimulation. Greater conversion of dehydroepiandrosterone (DHEA) into A with normal conversion of 17-OHPE to 17-OHP4 in hyperandrogenic PCOS patients indicated different levels of 3β-HSDII activity in adrenal cells, and hyperandrogenic patients had lower 11β-hydroxylase and 21-hydroxylase activities. Arq Bras Endocrinol Metab. 2013;57(6):437-44 Keywords Polycystic ovary syndrome; steroidogenesis; hyperandrogenism; enzyme activity; adrenal stimulation RESUMO Objetivo: O objetivo deste estudo foi examinar a atividade de enzimas responsáveis pela produção de corticosteroides em pacientes normo e hiperandrogênicas com síndrome de ovários policísticos (SOP). Sujeitos e métodos: A coorte estudada incluiu 81 pacientes com hiperandrogenismo bioquímico e 41 pacientes com níveis normais de androgênio. A atividade enzimática foi avaliada de acordo com as proporções de produto/precursor do esteroide sérico, no momento inicial do estudo e depois de estimulação adrenal. Resultados: No momento inicial, na via delta 4 (Δ4), as pacientes hiperandrogênicas mostraram maior atividade da 17-hidroxilase e 17,20 liase na conversão da progesterona (P4) em 17-hidroxiprogesterona (17-OHP4) e na conversão da 17-hidroxipregnenolona (17-OHPE) em androstenediona (A) (p = 0,0005 e p = 0,047, respectivamente) em comparação com pacientes normoandrogênicas. Na via delta 5 (Δ5), a 17-hidroxilase e a 17,20 liase mostraram atividades similares nos dois grupos. As pacientes hiperandrogênicas mostraram menor atividade da 21-hidroxilase, menor atividade da 11β-hidroxilase (p = 0,0001) e aumento estatisticamente significativo na atividade da 3β-hidroxiesteroide desidrogenase II (3β-HSDII) (p < 0.0001). Após a estimulação com tetracosactrin, apenas a ativi...

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Section: Methodsmentioning

confidence: 99%

New insights into steroidogenesis in normo- and hyperandrogenic polycystic ovary syndrome patients

Gil-Junior¹,

Barbosa

Isaías³

et al. 2013

Arq Bras Endocrinol Metab

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“…127 In athletes presenting with amenorrhea, laboratory testing should include a complete blood count and chemistry panel to rule out chronic illnesses associated with amenorrhea, beta-human chorionic gonadotropin testing to rule out pregnancy, thyroid-stimulating hormone and free thyroxine to test for primary and central thyroid dysfunction, prolactin to assess for a pituitary mass, and follicle-stimulating hormone to rule out ovarian insufficiency. 48 If hyperandrogenism is in the differential diagnosis, luteinizing hormone (to check for a luteinizing hormone:follicle-stimulating hormone ratio greater than 2:1, suggesting polycystic ovarian syndrome), 71 total testosterone and sex hormone binding globulin (to calculate the free androgen index), 132 and steroids dehydroepiandrosterone sulfate and 17-hydroxyprogesterone should also be included. 7,77 Many patients with hypothalamic amenorrhea present with a decreased estradiol level, but this is not necessary for diagnosis.…”

Section: Screening and Diagnosismentioning

confidence: 99%

The Female Athlete Triad

Nazem

Ackerman

2012

Sports Health: A Multidisciplinary Approach

122

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Context:The female athlete triad (the triad) is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density; it is relatively common among young women participating in sports. Diagnosis and treatment of this potentially serious condition is complicated and often requires an interdisciplinary team.Evidence Acquisition:Articles from 1981 to present found on PubMed were selected for review of major components of the female athlete triad as well as strategies for diagnosis and treatment of the conditions.Results:The main goal in treatment of young female athletes with the triad is a natural return of menses as well as enhancement of bone mineral density. While no specific drug intervention has been shown to consistently improve bone mineral density in this patient population, maximizing energy availability and optimizing vitamin D and calcium intake are recommended.Conclusions:Treatment requires a multidisciplinary approach involving health care professionals as well as coaches and family members. Prevention of this condition is important to minimize complications of the female athlete triad.

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“…Hirsutism has been correlated with increased levels of serum androgens. FT has been reported to have a stronger correlation with a clinical diagnosis [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Association between biochemical hyperandrogenism parameters and modified Ferriman-Gallwey score in patients with hirsutism in Basrah (Southern Iraq)

Hussein

Hamdi

Mansour

2021

pdia

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Introduction Hyperandrogenemia is the most frequent endocrine disorder in women causing a variety of adverse metabolic disturbances. Establishing the diagnosis of androgen overproduction has significant implications for the follow-up and treatment of patients. Aim To investigate the severity of hirsutism and its correlation with serum androgen in women with hirsutism from Basrah (Southern Iraq). Material and methods This was a cross-sectional study of 300 hirsute women, mean age: 26.6 ±7.1 years with a modified Ferriman and Gallwey (mFG) score of 8 or higher. Assessment of hirsutism severity was performed and hormonal markers including total testosterone (TT), calculated free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S), were measured. Results There was a significant correlation between the severity of hirsutism using mFG score and FT, TT levels ( p < 0.001 and p < 0.047, respectively), while no association was seen between mFG score and DHEA-S. Conclusions Our data suggest that FT and, to a less extent, TT were important biochemical hyperandrogenism markers that correlate with severity of hirsutism. DHEA-S was not found to be beneficial.

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Helpful diagnostic markers of steroidogenesis for defining hyperandrogenemia in hirsute women

Cited by 12 publications

References 22 publications

New insights into steroidogenesis in normo- and hyperandrogenic polycystic ovary syndrome patients

New insights into steroidogenesis in normo- and hyperandrogenic polycystic ovary syndrome patients

The Female Athlete Triad

Association between biochemical hyperandrogenism parameters and modified Ferriman-Gallwey score in patients with hirsutism in Basrah (Southern Iraq)

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