Hyperandrogenemia is Common in Asymptomatic Women and is Associated with Increased Metabolic Risk

Abstract

Objective Women with metabolic syndrome (MetS) have higher endogenous testosterone (T) levels than unaffected women. This study investigated whether hyperandrogenemia (HA) was a marker for increased cardiometabolic risk in reproductively normal premenopausal women. Methods Reproductive hormones and metabolic parameters were assessed in 198 women with regular menses and no clinical hyperandrogenism (eumenorrheic [EM]). Hyperandrogenic EM women were compared with 110 women with NIH criteria polycystic ovary syndrome. Results Twenty‐two percent of EM women had HA. Levels of non–sex hormone–binding globulin (SHBG)‐bound T were elevated in 68% of women, total T levels were elevated in 43% of women, and dehydroepiandrosterone sulfate levels were elevated in 30% of women. The prevalence of HA increased with BMI category (P = 0.01): 12% for BMI < 25 kg/m2, 22% for BMI of 25 to 30 kg/m2, and 31% for BMI ≥ 30 kg/m2. MetS (adjusted odds ratio 2.9; 95% CI: 1.2‐6.9) and dysglycemia risks (adjusted odds ratio 2.7; 95% CI: 1.2‐5.8) were increased in hyperandrogenic EM women compared with normoandrogenic EM women, with adjustment for BMI. SHBG levels were independently associated with these metabolic end points (P < 0.001), whereas androgen levels were not. A cluster analysis confirmed that there was a discrete subset of EM women with HA and metabolic abnormalities. Conclusions HA is common in EM women and is associated with increased risks for MetS and dysglycemia. However, low SHBG levels rather than elevated androgen levels may be the primary predictor of this relationship with metabolic dysfunction.

Mechanisms of probiotic modulation of ovarian sex hormone production and metabolism: a review

“…For instance, abnormal expression of estrogen or its receptor is associated with the development of ovarian tumours, 8 while hypersecretion of androgens may lead to acne 9 and hyperandrogenism. 10 The development of sex hormone disorders in women may lead to various health complications. For example, polycystic ovary syndrome (PCOS), a prevalent endocrine condition affecting women globally, is characterized by irregular menstruation, polycystic ovaries, and hyperandrogenism.…”

Non-PCOS Hyperandrogenic Disorders in Adolescents

“…Clinical hyperandrogenism (e.g., hirsutism) is commonly an important concern to patients and may negatively impact psychological and social well-being. Moreover, non-PCOS-related hyperandrogenism may indicate (or contribute to) risks of elevated body mass index (BMI), metabolic syndrome, and dysglycemia, 6 much like the well-known association of PCOS with features of metabolic syndrome. 7 Several conditions other than PCOS should be considered in each adolescent presenting with hyperandrogenism, in large part because treatment approaches and comorbidities may differ from those of PCOS.…”