Influence of adrenal hyperandrogenism on the clinical and metabolic phenotype of women with polycystic ovary syndrome

Alpañés, Macarena; Luque‐Ramírez, Manuel; Martínez‐García, M. Ángeles; Fernández‐Durán, Elena; Álvarez‐Blasco, Francisco; Escobar-Morreale, Héctor F.

doi:10.1016/j.fertnstert.2014.12.105

Cited by 33 publications

(28 citation statements)

References 45 publications

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“…A total score R8 was considered abnormal, and hirsutism was graded as mild (mFG [8][9][10][11][12][13][14] or moderate to severe (mFG R15) (10). We recorded BMI (kg/m 2 ) and BMI category (lean (BMI !25 kg/m 2 ), overweight (25-29.9 kg/m 2 ) and obesity (BMI R30 kg/m 2 )).…”

Section: Population Demographics and Other Methodsmentioning

confidence: 99%

Referral bias in female functional hyperandrogenism and polycystic ovary syndrome

Luque‐Ramírez

Alpañés

Sanchón

et al. 2015

European Journal of Endocrinology

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Objective: Women with polycystic ovary syndrome (PCOS) seeking health care in the United States may be more obese and hyperandrogenic than those present in the general population. We aimed to assess the impact of referral bias on European women with functional androgen excess disorders. Design: Cross-sectional study. Methods: We studied two groups of patients: i) 368 consecutive patients referred to our clinic for the study of functional hyperandrogenism (FH) (referral patients); ii) 57 consecutive premenopausal patients identified by screening during blood donation (unselected patients). We compared the anthropometric data from the groups of patients with those of two control populations: iii) a group of unselected premenopausal healthy female blood donors (unselected controls); and iv) data available from the local general premenopausal female population. Results: Referral patients with FH were more hirsute, had a higher percentage of hyperandrogenemia, and fulfilled PCOS criteria more frequently than unselected patients. The prevalence of obesity in unselected controls was similar to that observed in the general population, whereas referral patients and unselected patients were more frequently obese. The prevalence of obesity was also higher among referral patients compared to unselected patients. Conclusion: Referral bias influences the phenotype of patients with FH. Patients studied at the clinical setting may show more severe hyperandrogenic and obese phenotypes than patients from the general population, even though PCOS appears to be associated with weight excess also in the general European population. This fact should be considered when establishing reference values and control populations for clinical and research purposes.

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Section: Population Demographics and Other Methodsmentioning

confidence: 99%

Referral bias in female functional hyperandrogenism and polycystic ovary syndrome

Luque‐Ramírez

Alpañés

Sanchón

et al. 2015

European Journal of Endocrinology

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

Wagner

Sahlin

Savchuk

et al. 2018

Obesity

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“…The presence of adrenal androgen excess, expressed by elevated DHEA-S concentrations, has been postulated to contribute to a favorable metabolic ( 9 , 10 , 11 ) and cardiovascular profile ( 12 , 13 ) in women with PCOS, as well as in the general population ( 14 , 15 ). However, scientific evidence is controversial, as other studies suggest a negative impact of adrenal hyperandrogenism on metabolic disturbances, including insulin resistance and hypertension in both PCOS ( 16 ) and in middle-aged individuals ( 17 ). Therefore, the exact influence of adrenal androgens on the metabolic aspects of PCOS remains inconclusive and requires further investigation.…”

Section: Introductionmentioning

confidence: 99%

Adrenal hyperandrogenism does not deteriorate insulin resistance and lipid profile in women with PCOS

Paschou

Palioura

Ioannidis

et al. 2017

Endocrine Connections

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ObjectiveThe aim of this study was to investigate the impact of adrenal hyperandrogenism on insulin resistance and lipid profile in women with polycystic ovary syndrome (PCOS).Patients and methodsWe studied 372 women with PCOS according to the NIH criteria. 232 age- and BMI-matched women served as controls in order to define adrenal hyperandrogenism (DHEA-S >95th percentile). Then, patients with PCOS were classified into two groups: with adrenal hyperandrogenism (PCOS-AH, n = 108) and without adrenal hyperandrogenism (PCOS-NAH, n = 264). Anthropometric measurements were recorded. Fasting plasma glucose, insulin, lipid profile, sex hormone-binding globulin (SHBG) and androgen (TT, Δ4A, DHEA-S) concentrations were assessed. Free androgen index (FAI) and homeostatic model assessment-insulin resistance (HOMA-IR) index were calculated.ResultsWomen with PCOS-AH were younger than PCOS-NAH (P < 0.001), but did not differ in the degree and type of obesity. No differences were found in HOMA-IR, total cholesterol, HDL-c, LDL-c and triglyceride concentrations (in all comparisons, P > 0.05). These metabolic parameters did not differ between the two groups even after correction for age. Women with PCOS-AH had lower SHBG (29.2 ± 13.8 vs 32.4 ± 11.8 nmol/L, P = 0.025) and higher TT (1.0 ± 0.2 vs 0.8 ± 0.4 ng/mL, P = 0.05) and Δ4A (3.9 ± 1.2 vs 3.4 ± 1.0 ng/mL, P = 0.007) concentrations, as well as FAI (14.1 ± 8.0 vs 10.2 ± 5.0, P < 0.001). These results were confirmed by a multiple regression analysis model in which adrenal hyperandrogenism was negatively associated with age (P < 0.001) and SHBG concentrations (P = 0.02), but not with any metabolic parameter.ConclusionsWomen with PCOS and adrenal hyperandrogenism do not exhibit any deterioration in insulin resistance and lipid profile despite the higher degree of total androgens.

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Influence of adrenal hyperandrogenism on the clinical and metabolic phenotype of women with polycystic ovary syndrome

Cited by 33 publications

References 45 publications

Referral bias in female functional hyperandrogenism and polycystic ovary syndrome

Referral bias in female functional hyperandrogenism and polycystic ovary syndrome

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

Adrenal hyperandrogenism does not deteriorate insulin resistance and lipid profile in women with PCOS

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