Longitudinal analyses of the steroid metabolome in obese PCOS girls with weight loss

Reinehr, Thomas; Kulle, Alexandra; Rothermel, Juliane; Knop-Schmenn, Caroline; Lass, Nina; Bosse, Christina; Holterhus, Paul‐Martin

doi:10.1530/ec-17-0051

Cited by 19 publications

(15 citation statements)

References 45 publications

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“…Three studies were excluded because of having incomplete outcome data [35], repetitive data [36], and one being a longitudinal design study [37]. The results for risk of bias are shown in Table 2 in the supplementary file.…”

Section: Resultsmentioning

confidence: 99%

Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis

et al. 2020

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Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age. This study aimed to compare the effects of lifestyle interventions on anthropometric, clinical, and biochemical parameters in adolescent girls with PCOS. Methods: PubMed, Scopus, and Web of Science was systematically searched to retrieve studies investigating the effects of lifestyle modifications in adolescent girls with PCOS, which were published up to December 2019. The primary outcome was Body Mass Index (BMI) and secondary outcomes were all manifestations of PCOS, including clinical, metabolic, and hormonal parameters. Random effect meta-analysis was applied for significant results. Publication bias was assessed using the Egger test. Results: This study showed significant improvements in luteinizing hormone (LH) (Pooled SMD = − 0.1.23; 95% CI, − 2.44 to − 0.03), and Free Androgen Index (FAI) levels (Pooled SMD = − 0.78 95% CI, − 0.1.42 to − 0.13) in adolescent girls receiving lifestyle intervention compared to baseline. This study also revealed that diet modifications alone were associated with a significant decrease in Body Mass Index (BMI) (Pooled SMD = − 0.45; 95% CI, − 0.76 to − 0.13), and FG score (Pooled SMD = − 0.81; 95% CI, − 1.33 to − 0.28). Exercise interventions were associated with significant changes in the menstrual cycles (Pooled SMD = 1.16; 95% CI, 0.72 to 1.61), Ferriman-Gallwey (FG) score (Pooled SMD = − 0.57; 95% CI, − 0.99 to − 0.15), LH (Pooled SMD = − 056; 95% CI, − 0.98 to − 0.14), Anti-Müllerian Hormone (AMH) (Pooled SMD = − 0.81; 95% CI, − 0.1.24 to − 0.38), and Triglyceride (TG) levels (Pooled SMD = − 0.32; 95% CI, − 0.62 to − 0.02).

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Section: Resultsmentioning

confidence: 99%

Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis

et al. 2020

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“…Compared to 17OHP, 21DF may be better for diagnosing adults with non-classic CAH due to 21OHD (24, 25). Whether 21DF is better than 17OHP to differentiate other disorders with elevated 17OHP, such as PCOS needs to be evaluated (26, 27).…”

Section: Discussionmentioning

confidence: 99%

Assay of steroids by liquid chromatography–tandem mass spectrometry in monitoring 21-hydroxylase deficiency

Dahl

Nermoen

Brønstad

et al. 2018

Endocrine Connections

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Immunoassays of steroid hormones are still used in the diagnosis and monitoring of patients with congenital adrenal hyperplasia. However, cross-reactivity between steroids can give rise to falsely elevated steroid levels. Here, we compare the use of immunoassays and liquid chromatography–tandem mass spectrometry (LC–MS/MS) in the monitoring of patients with classic 21-hydroxylase deficiency (21OHD). Steroid profiles in different mutation groups (genotypes) were also compared. Fifty-five patients with classic 21OHD (38 women) were studied. Blood samples were collected in the morning after an overnight medication fast. LC–MS/MS and immunoassays were employed to assay 17-hydroxyprogesterone (17OHP), testosterone and androstenedione. In addition, 21-deoxycortisol (21DF), 11-deoxycortisol (11DF), corticosterone, deoxycorticosterone, cortisone and cortisol were analyzed by LC–MS/MS. Testosterone, androstenedione and 17OHP levels were consistently lower (by about 30–50%) when measured by LC–MS/MS compared with immunoassays, with exception of testosterone in men. There was a significant correlation between 21DF and 17OHP (r = 0.87, P < 0.001), but three patients had undetectable 21DF. Subjects with no enzyme activity had significantly lower mean 11DF concentrations than subjects with residual activity. The use of LC–MS/MS gives a more specific view of adrenal steroid levels in 21OHD compared with immunoassays, which seem to considerably overestimate the levels of 17OHP and androstenedione. Falsely elevated levels of 17OHP and androstenedione could lead to overtreatment with glucocorticoids.

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“…Only recently, LC–MS/MS-based longitudinal measurements of androgens were reported in 40 obese girls with adolescent PCOS (33). Interestingly, that study reported elevated A4 and testosterone levels, but normal DHEAS compared to BMI-matched controls.…”

Section: Discussionmentioning

confidence: 99%

Causes, patterns and severity of androgen excess in 487 consecutively recruited pre- and post-pubertal children

Idkowiak

Elhassan

Mannion

et al. 2019

European Journal of Endocrinology

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ObjectiveAndrogen excess in childhood is a common presentation and may signify sinister underlying pathology. Data describing its patterns and severity are scarce, limiting the information available for clinical decision processes. Here, we examined the differential diagnostic value of serum DHEAS, androstenedione (A4) and testosterone in childhood androgen excess.DesignRetrospective review of all children undergoing serum androgen measurement at a single center over 5 years.MethodsSerum A4 and testosterone were measured by tandem mass spectrometry and DHEAS by immunoassay. Patients with at least one increased androgen underwent phenotyping by clinical notes review.ResultsIn 487 children with simultaneous DHEAS, A4 and testosterone measurements, we identified 199 with androgen excess (140 pre- and 59 post-pubertal). Premature adrenarche (PA) was the most common pre-pubertal diagnosis (61%), characterized by DHEAS excess in 85%, while A4 and testosterone were only increased in 26 and 9% respectively. PCOS was diagnosed in 40% of post-pubertal subjects, presenting equally frequent with isolated excess of DHEAS (29%) or testosterone (25%) or increases in both A4 and testosterone (25%). CAH patients (6%) predominantly had A4 excess (86%); testosterone and DHEAS were increased in 50 and 33% respectively. Concentrations increased above the two-fold upper limit of normal were mostly observed in PA for serum DHEAS (>20-fold in the single case of adrenocortical carcinoma) and in CAH for serum androstenedione.ConclusionsPatterns and severity of childhood androgen excess provide pointers to the underlying diagnosis and can be used to guide further investigations.

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Longitudinal analyses of the steroid metabolome in obese PCOS girls with weight loss

Cited by 19 publications

References 45 publications

Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis

Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis

Assay of steroids by liquid chromatography–tandem mass spectrometry in monitoring 21-hydroxylase deficiency

Causes, patterns and severity of androgen excess in 487 consecutively recruited pre- and post-pubertal children

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