Elevated serum androstenedione is associated with a more severe phenotype in women with polycystic ovary syndrome (PCOS)
To evaluate the impact of elevated serum Δ4A levels on the hormonal and metabolic features of the different phenotypes of PCOS.
1276 women with PCOS according to the Rotterdam criteria were included, in whom serum hormonal levels were determined.
In PCOS women as a whole, as well as in patients presenting clinical and/or biochemical hyperandrogenemia (phenotypes I and II), Δ4A levels >3.8 ng/ml were positively related to LH, LH/FSH ratio, T, DHEAS, 17 OH progesterone and FAI and negatively related to T/Δ4A ratio. In the milder phenotype III, a positive correlation between Δ4A levels >3.8 ng/ml and T, DHEAS, 17 OH progesterone and FAI and a negative one between increased Δ4A and T/Δ4A ratio were reported. In the whole PCOS group with androstenedione >3.8 ng/ml, an increased ovarian volume was observed, while a greater mean follicular number was found only in phenotypes I and II.
Increased serum Δ4A levels, which are associated with more severe PCOS phenotypes, possibly contribute to the worsening of PCOS features and therefore could be a valuable marker of biochemical hyperandrogenemia.
Key wordsAdrenals Androstenedione Androstenedione/Testosterone ratio Insulin resistance PCOS
Unable to display preview. Download preview PDF.
- 2.The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group, 2004 Revised 2003 consensus on the diagnostic criteria and long term health risks related to polycystic ovary syndrome. Fertil Steril 81: 19–25.Google Scholar
- 13.Azziz R, Carmina E, Dewailly D, et al, 2009 Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 91: 456–488.CrossRefPubMedGoogle Scholar