Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS)

Kumar, Abhishek; Woods, Keslie S.; Bartolucci, Alfred A.; Azziz, Ricardo

doi:10.1111/j.1365-2265.2005.02256.x

Cited by 214 publications

(140 citation statements)

References 33 publications

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“…In contrast to these findings, two studies found decreased DHEAS levels in Black and Mexican American vs. white women with PCOS (23;24). Using race specific cut offs, black women with PCOS had increased prevalence of high DHEAS levels (23) suggesting that adrenal activity may differ between some ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Glintborg

Mumm

Hougaard

et al. 2010

Clinical Endocrinology

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To cite this version:Dorte Glintborg, Hanne Mumm, David Hougaard, Pernille Ravn, Marianne Andersen. Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark. Clinical Endocrinology, Wiley, 2010, 73 (6) Design: Retrospective trans-sectional study.Patients: 1002 premenopausal women with the diagnoses hirsutism or PCOS were divided according to ethnicity: Caucasian (CA, n=784), Middle East (ME, n=190), Asian (n=14), other (n=14).Measurements: Clinical evaluation (hirsutism, BMI, waist, blood pressure), hormone analyses (testosterone, sex hormone binding globulin, prolactin, lipids, insulin, glucose), and transvaginal ultrasound. Oral glucose tolerance tests (OGTT) (n = 499) and ACTH tests (n = 434) were performed in a subgroup of patients.Results (CA vs. ME women): CA women were older [32(25-37) vs. 25(18-32) years, median (quartiles)]and had increased BMI compared to ME women. After correcting for age and BMI CA women were less hirsute, but had increased testosterone levels compared to ME women. The Rotterdam criteria were fulfilled in 56% of both populations but PCO was diagnosed in 47% CA vs. 29% ME women, p<0.01. CA women had increased blood pressure and smoked at a higher frequency (40 vs. 23%), whereas area under the curve for insulin during OGTT was decreased, all p<0.001. Prolactin levels were significantly lower in CA women compared to ME women [7(5-10) vs. 9(6-12) µg/l] and were inversely associated with smoking status. Conclusion:CA women had a more adverse cardiovascular profile than ME women, whereas insulin sensitivity was higher. The prevalence of the individual Rotterdam criteria differed significantly in the two study populations.

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Section: Discussionmentioning

confidence: 99%

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Glintborg

Mumm

Hougaard

et al. 2010

Clinical Endocrinology

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“…Hypoandrogenism is a consistent finding in male patients with MS [84]. In females, androgen metabolism is also altered, especially in those affected by polycystic ovary syndrome [85]. In all cases, the levels of dehydroepiandrosterone tend to be low [86] because of altered adrenal function, as in advanced age.…”

Section: Sex Hormonesmentioning

confidence: 65%

Metabolic Syndrome: A Multifaceted Disease of Affluence

Alemany

2012

J Endocrinol Metab

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Metabolic syndrome developed in consequence of an evolutionary inadequacy: the human body was unprepared for a dietary excess of nutrients, especially lipids (largely in detriment of carbohydrate). This excess awakens metabolic signals akin to those of starvation, in which the main energy staple is the body's own lipid reserve. Lipid dietary abundance prevents the use of glucose, which in turn limits the oxidation of amino acids. To ward against a subsequent avalanche of substrates, the immune system and hypertrophied tissues (for example, adipose) elicit a series of defence responses. This response is probably the ultimate basis of a disease that is manifested as various pathologies, which were initially defined as distinct entities but which are slowly being seen as a single pathognomic unit in the literature. Based on their common origin of the ample availability of food in our modern society, the cluster of diseases comprising the metabolic syndrome is probably best described as a single multifaceted disease.

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“…Certain studies have revealed higher levels of testosterone in the follicular fluid of patients with PCOS (37,38). Hyperandrogenism in PCOS may proceed via dysregulated paracrine/endocrine control of androgen synthesis (37), or result from adrenal androgen excess (39,40). Intraovarian androgens have been found to promote GC proliferation and inhibit GC apoptosis in PCOS patients, particularly in small follicles whose GCs are rich in androgen receptors (35,36), indicating that androgens may have a crucial effect on GC development, and intraovarian androgen may play an important role in the pathogenesis of PCOS via regulating early follicle growth.…”

Section: Discussionmentioning

confidence: 99%

HOXA10 expression is decreased by testosterone in luteinized granulosa cells in vitro

Tian

Yin

et al. 2012

Mol Med Report

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Abstract. Polycystic ovary syndrome (PCOS) is perhaps the most prevalent endocrine disorder in women of reproductive age, characterized by elevated levels of circulating androgens or clinical manifestations of androgen excess. The specific cytokine profile of PCOS patients is probably related to the lower implantation rate, since follicular fluid appears to function as an embryotrophic agent. For a better understanding of the local regulation of human follicles, the present study investigated the protein expression levels and cellular localization of HOXA10 in granulosa cells (GCs) from women with normal ovarian function undergoing IVF due to their husbands suffering from azoospermia. We demonstrated by immunohistochemical studies that the expression of HOXA10 was mainly localized in the cytoplasm of GCs. Our data indicate that these alterations were associated with changes in the expression of ovarian transcription factors of HOXA10. GC dose-responsive decreases in HOXA10 protein were observed in response to physiological or supraphysiological concentrations (10 -4 to 10 -7 M) of testosterone. These data reveal that testosterone may be involved in HOXA10 gene regulation in GCs. Decreased HOXA10 expression in GCs treated with testosterone suggest that this androgen is responsible for the decreased expression of HOXA10 in PCOS patients.

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Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS)

Cited by 214 publications

References 33 publications

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Metabolic Syndrome: A Multifaceted Disease of Affluence

HOXA10 expression is decreased by testosterone in luteinized granulosa cells in vitro

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