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

Abstract

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.

Increased Ratio of Total Testosterone to Dihydrotestosterone May Predict an Adverse Metabolic Outcome in Polycystic Ovary Syndrome

“…PCOS is a heterogeneous disease with several metabolic characteristics, clinical phenotypes and HA as a key factor. The present study observed that the TT/DHT ratio was higher in PCOS women with adverse metabolic parameters, and a higher TT/DHT ratio was observed within PCOS patients who had MetS and IGT; similar observations were made in recent studies [13,14,24]. These findings were also supported by significant correlations with parameters of glucose intolerance (i.e.…”

“…When TT/DHT ratio cutoff of ≥ 2.38 was used to diagnose PCOS, it was interestingly observed that 32.5% of control women also had a high ratio. These observations of high ratio may also be associated with adverse metabolic profile not only in PCOS but also in control women with metabolic derangements; Ambroziak et al (2017) also made similar observations [14]. 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.…”

“…Sample size was estimated according to a previous study [15]. Forty Bangladeshi women aged 16 -35 years with PCOS diagnosed on the basis of revised Rotterdam consensus 2003 criteria [1,14] were recruited. Control group included 40 age-matched healthy women having regular menstrual cycle, no history of clinical and biochemical HA, no polycystic ovary morphology on ultrasonography (USG) and without clinical evidence of any endocrine diseases.…”

“…It is estimated that more than 60% DHT in women is produced from the skin and originates from androstenedione. Recent studies have shown that a high total testosterone to dihydrotestosterone (TT/DHT) ratio was useful to see an adverse metabolic profile not only in PCOS patients but also useful to predict development of PCOS in "theoretically healthy" obese women [13,14]. The present study was undertaken to analyze whether the TT/DHT ratio may be helpful in predicting metabolic risk in PCOS women.…”

Salivary testosterone may not serve as a screening test in the diagnosis of biochemical hyperandrogenism

“…Analysis of albumin concentrations was performed using Cobas diagnostic kits and SHBG by ELISA DRG. The data were already partially described …”