Testosterone to Dihydrotestosterone Ratio as a New Biomarker for an Adverse Metabolic Phenotype in the Polycystic Ovary Syndrome

Münzker, Julia; Hofer, Doris; Trummer, Christian; Ulbing, Matthias; Harger, Alexandra; Pieber, Thomas R.; Owen, Laura; Keevil, Brian; Brabant, Georg; Lerchbaum, Elisabeth; Obermayer-Pietsch, B.

doi:10.1210/jc.2014-2523

Cited by 89 publications

(65 citation statements)

References 27 publications

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“…In fact, increasing evidence supports that androgen excess represents a constitutive biomarker of PCOS. As expected, an androgen profile rather than testosterone alone should be used, as documented by several recent studies (12,13,14,15,16,18). A fundamental prerequisite is represented by the fact that if different androgens are needed to fully define hyperandrogenemia in these women, it could be that different mechanisms may be involved in regulating the enzyme activity involved in the androgen production rate or in their metabolic clearance rate (18).…”

Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 96%

“…Several recent studies have shown that extremely accurate and sensitive technologies in the detection and analysis of steroids, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS) (8), have significantly improved the definition of the androgenemic blood pattern in women with PCOS (11,12,13,14,15,16,17,18). These studies have clearly shown that a steroid profile, including not only testosterone blood levels but also androstenedione and the free androgen index (FAI), may optimize the diagnosis of hyperandrogemia in women with PCOS, therefore improving our understanding on the heterogeneity of its phenotypes.…”

Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 99%

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MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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PCOS is a clinical heterogeneous entity of female androgen excess diagnosed by exclusion of other disorders responsible for androgen excess. The concept of secondary PCOS implies that there is a primary well-defined cause leading to the PCOS phenotype with underlying androgen overproduction, regardless of the origin. In these cases, we presume the term of 'secondary PCOS' could be used. In all these conditions, the potential complete recovery of the hyperandrogenemic state as well as the remission of the PCOS phenotype should follow the removal of the cause. If accepted, these concepts could help clinicians to perform in-depth investigations of the potential factors or disorders responsible for the development of these specific forms of secondary PCOS. Additionally, this could contribute to develop further research on factors and mechanisms involved in the development of the classic and the nonclassic PCOS phenotypes. Invited author's profileRenato Pasquali is full professor of Endocrinology & Metabolism and Director of the division of Endocrinology of the S.Orsola-Malpighi Hospital, Bologna, Italy. He also heads the School of Specialization in Endocrinology and Metabolism, University Alma Mater Studiorum of Bologna, Italy. He is a member of numerous national and international scientific societies and serves on the editorial boards of international journals. His scientific interests relate to (i) the pathophysiology and treatment of the polycystic ovary syndrome; (ii) the endocrinology of obesity (sex hormones, the hypothalamic-pituitary-adrenal axis, and the endocannabinoid system).

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Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 96%

Section: Arguments In Favor Of the Definition Of Secondary Pcosmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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“…Therefore, there is the need to identify predictors that would help to identify PCOS patients with the highest metabolic risk. Münzker et al proposed total testosterone/dihydrotestosterone ratio (TT/DHT) as an indicator of a worse metabolic prognosis in PCOS [4]. Metabolic disturbances observed in patients with PCOS result from the unfavorable influence of androgens on glucose and lipid metabolism as well as on insulin action.…”

Section: Introductionmentioning

confidence: 99%

Total testosterone to dihydrotestosterone ratio assessed by LC-MS/MS predicts a worse metabolic profile not only in PCOS patients

et al. 2017

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Objectives: Total testosterone/dihydrotestosterone ratio (TT/DHT) was found to determine metabolic risk in polycystic ovary syndrome (PCOS). The aim of this study was to analyze whether (TT/DHT) may be helpful in predicting metabolic risk not only in PCOS patients but also in healthy women. Material and methods:Total testosterone (TT), dihydrotestosterone (DHT), androstendione and dehydroepiandrosterone sulphate (DHEA-S) were measured by LC-MS/MS in 36 women with PCOS and in 29 age-matched controls without clinical hyperandrogenism. In all participants, anthropometric data, lipids, adipose tissue percent (%fat), HOMA-IR were also assessed. Results:The studied groups were not different in terms of age, BMI, waist circumference, %fat and HOMA-IR. In the patients group, mean TT and androstendione levels were significantly higher as compared to controls (1.4 nmol/L vs. 1.0 nmol/L, P < 0.001) and (6.6 nmol/L vs. 4.9 nmol/L, P < 0.01), respectively. In the patients group, mean TT/DHT ratio was significantly higher compared to controls (3.6 vs. 2.7, P < 0.01) and correlated with BMI (r = 0.37, P < 0.05), waist circumference (r = 0.44, P < 0.01), %fat (r = 0.30, P < 0.05), as well as with insulin levels (r = 0.38, P < 0.05) and HOMA-IR (r = 0.44, P < 0.05). The association between TT/DHT ratio and unfavorable metabolic parameters was also seen in controls. Conclusion:Total testosterone/dihydrotestosterone ratio assessed by LC-MS/MS correlates with a worse metabolic profile not only in PCOS patients, but also in healthy women.

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“…Selenium supplementation may result in decreased serum DHEA levels and hirsutism through improved markers of insulin metabolism [13] and decreased oxidative stress [12]. Previous studies have demonstrated that a positive association between hyperandrogenism, hyperinsulinemia, and insulin resistance in females with elevated androgen levels due to PCOS [45,46]. In addition, oxidative stress is directly correlated with both insulin resistance and hyperandrogenism, which in turn contribute to endocrine and biochemical alterations in women with functional ovarian hyperandrogenism (FOH) [47].…”

mentioning

confidence: 99%

Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome

et al. 2015

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Selenium supplementation could be effective on reproductive outcomes, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS). The aim of the study was to determine the effects of selenium supplementation on reproductive outcomes, biomarkers of inflammation, and oxidative stress in PCOS patients. The present randomized double-blind, placebo-controlled trial was conducted on 64 women aged 18?40 years old with PCOS at the clinic affiliated to Ardabil University of Medical Sciences, Ardabil, Iran. The participants were randomly assigned to 2 groups receiving either 200??g selenium daily (n=32) or placebo (n=32) for 8 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were measured and compared both before and after the treatment. After 8 weeks of intervention, pregnancy rate in the selenium group was higher than in the placebo group: 18.8 (6/32) vs. 3.1% (1/32), p=0.04. In addition, alopecia (40.6 vs. 9.4%, p=0.004) and acne (46.9 vs. 12.5 %, p=0.003) decreased following the consumption of selenium supplements compared with placebo. Additionally, patients who received selenium supplements had significantly decreased serum dehydroepiandrosterone (DHEA) levels (p=0.02), hirsutism (modified Ferriman?Gallwey scores) (p<0.001), serum high sensitivity C-reactive protein (hs-CRP) (p=0.02), and plasma malondialdehyde (MDA) levels (p=0.01) compared with placebo. We did not observe any significant effects of taking selenium supplements on other hormonal profiles, nitric oxide (NO), and other biomarkers of oxidative stress. Taken together, selenium supplementation for 8 weeks among PCOS women had beneficial effects on reproductive outcomes, DHEA, hs-CRP, and MDA levels.

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Testosterone to Dihydrotestosterone Ratio as a New Biomarker for an Adverse Metabolic Phenotype in the Polycystic Ovary Syndrome

Abstract: Our data provide evidence for a strong link between a high TT/DHT ratio and an adverse metabolic phenotype in PCOS patients. This correlation was only found in PCOS patients, suggesting the TT/DHT ratio to be a new biomarker for an adverse metabolic phenotype in PCOS patients.

Cited by 89 publications

References 27 publications

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Total testosterone to dihydrotestosterone ratio assessed by LC-MS/MS predicts a worse metabolic profile not only in PCOS patients

Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome

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