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

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    Authors
    Münzker, J
    Hofer, D
    Trummer, C
    Ulbing, M
    Harger, A
    Pieber, T
    Owen, L
    Keevil, B
    Brabant, Georg E
    Lerchbaum, E
    Obermayer-Pietsch, B
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    Affiliation
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
    Issue Date
    2014-11-11
    
    Metadata
    Show full item record
    Abstract
    Context: ovary syndrome (PCOS) is a heterogeneous disease with many different aspects, including hyperandrogenism and metabolic disturbances. Clinical phenotypes show different patterns of steroid hormones that have been investigated to some extent. Objective: This study intended to determine the role of the testosterone (TT) to dihydrotestosterone (DHT) ratio (TT/DHT ratio) in PCOS patients and to further assess the correlation of this ratio with hormonal, anthropometric, and metabolic parameters. Design and Setting: Serum samples of 275 premenopausal PCOS patients fulfilling Rotterdam criteria and 35 BMI-matched, premenopausal, healthy controls were analyzed for testosterone, dihydrotestosterone, dehydroepiandrosterone (DHEA), and androstenedione using liquid chromatography/mass spectrometry. Main Outcome Measures: We measured total levels of testosterone and dihydrotestosterone and calculated unbound hormone levels as well as the ratio of testosterone to dihydrotestosterone. Further, impaired glucose tolerance, basal and stimulated serum insulin levels, metabolic syndrome and insulin resistance according to the homeostatic model assessment (HOMA-IR) were assessed. Results: PCOS patients showed significantly higher levels of TT (p < 0.001), free testosterone (p < 0.001), and free DHT (p < 0.001) compared to healthy controls. The TT/DHT ratio was significantly higher in PCOS patients (p < 0.001). No difference was found for total DHT levels (p = 0.072). In PCOS patients alone, the TT/DHT ratio was significantly higher in obese patients (p < 0.001) and patients with metabolic syndrome (p < 0.001), impaired glucose tolerance (IGT) (p < 0.001) or insulin resistance (p < 0.001). Significant correlations of the TT/DHT ratio with various adverse anthropometric, hormonal, lipid and liver parameters and parameters of glucose metabolism were found. Conclusion: 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.
    Citation
    Testosterone to Dihydrotestosterone Ratio as a New Biomarker for an Adverse Metabolic Phenotype in the Polycystic Ovary Syndrome. 2014:jc20142523 J Clin Endocrinol Metab
    Journal
    Journal of Clinical Endocrinology and Metabolism
    URI
    http://hdl.handle.net/10541/336217
    DOI
    10.1210/jc.2014-2523
    PubMed ID
    25387259
    Type
    Article
    Language
    en
    ISSN
    1945-7197
    ae974a485f413a2113503eed53cd6c53
    10.1210/jc.2014-2523
    Scopus Count
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