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Association Between Androgen Receptor Gene CAG Repeat Polymorphism and Plasma Testosterone Levels in Postmenopausal Women

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Abstract

Objectives

The biologic action of androgens in target cells depends on plasma androgen levels and receptor transcriptional activity. We investigated the relationship between androgen receptor (AR) CAG repeat polymorphism, serum androgen levels, and anthropometric, metabolic, and hormonal variables in 39 postmenopausal women, taking into consideration the patterns of X-chromosome inactivation.

Methods

Genomic DNA was extracted from peripheral leukocytes. Polymerase chain reactions (PCRs) were performed to amplify the polymorphic (CAG)n repeat of the human AR gene, which were analyzed with GeneScan software (Applied Biosystems, Foster City, CA). The X-chromosome inactivation analysis was based on the AR gene methylation patterns.

Results

The mean age of participants was 54.7 years; mean age at menopause was 48 years. The number of CAG repeats ranged from 15 to 30, with a median length of 23. Analysis of X-chromosome inactivation patterns showed 19 cases with a degree of skewing (DS) ≥70% and seven with a DS ≥90%. The X-weighted CAG repeat biallelic mean was significantly lower in individuals with total testosterone (TT) greater than 0.56 ng/mL (group mean) than in the group with TT ≤ 0.56 (P =.018). No difference was observed between the groups regarding dehydroepiandrosterone sulfate (DHEA-S). Plasma TT was significantly higher in the group with the smaller X-weighted CAG repeat biallelic mean (P =.01). Free androgen index (FAI) was also significantly higher in this group (P =.033). Testosterone levels and FAI were inversely correlated to X-weighted CAG repeat biallelic mean.

Conclusion

Our data indicate an association between testosterone plasma levels and AR CAG repeats in postmenopausal women, and suggest that plasma levels of androgens in postmenopausal women may be related to variants of the AR gene.

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References

  1. Gobinet J, Poujol N, Sultan C. Molecular action of androgens. Mol Cell Endocrinol 2002;198:15–24.

    Article  CAS  PubMed  Google Scholar 

  2. Lubahn DB, Joseph DR, Sar M, et al. The human androgen receptor: Complementary deoxyribonucleic acid cloning, sequence analysis and gene expression in prostate. Mol Endocrinol 1988;2:1265–75.

    Article  CAS  PubMed  Google Scholar 

  3. Vottero A, Stratakis CA, Ghizzoni L, Longui CA, Karl M, Chrousos GP. Androgen receptor- mediated hypersensitivity to androgens in women with nonhyperandrogenic hirsutism: Skewing of X-chromosome inactivation. J Clin Endocrinol Metab 1999;84:1091–5.

    CAS  PubMed  Google Scholar 

  4. Tut TG, Ghadessy FJ, Trifiro MA, Pinsky L, Yong EL. Long polyglutamine tracts in the androgen receptor are associated with reduced trans-activation, impaired sperm production, and male infertility. J Clin Endocrinol Metab 1997;82:3777–82.

    CAS  PubMed  Google Scholar 

  5. Yu H, Bharaj B, Vassilikos EJ, Giai M, Diamandis EP. Shorter CAG repeat length in the androgen receptor gene is associated with more aggressive forms of breast cancer. Breast Cancer Res Treat 2000;59:153–61.

    Article  CAS  PubMed  Google Scholar 

  6. Ferro P, Catalano MG, Dell’Eva R, Fortunati N, Pfeffer U. The androgen receptor CAG repeat: A modifier of carcinogenesis? Mol Cell Endocrinol 2002;193:109–20.

    Article  CAS  PubMed  Google Scholar 

  7. Giovannucci E, Stampfer MJ, Krithivas K, et al. The CAG repeat within the androgen receptor gene and its relationship to prostate cancer. Proc Natl Acad Sci USA 1997;94:3320–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Correa-Cerro L, Wohr G, Haussler J, et al. (CAG)nCAA and GGN repeats in the human androgen receptor gene are not associated with prostate cancer in a French-German population. Eur J Hum Genet 1999;7:357–62.

    Article  CAS  PubMed  Google Scholar 

  9. Calvo RM, Asuncion M, Sancho J, San Millan JL, Escobar HF. The role of the CAG repeat polymorphism in the androgen receptor gene and of skewed X-chromosome inactivation, in the pathogenesis of hirsutism. J Clin Endocrinol Metab 2000;85:1735–40.

    CAS  PubMed  Google Scholar 

  10. Beilin J, Ball EM, Favaloro JM, Zajac JD. Effect of the androgen receptor CAG repeat polymorphism on transcriptional activity: specificity in prostate and non-prostate cell lines. J Mol Endocrinol 2000;25:85–96.

    Article  CAS  PubMed  Google Scholar 

  11. Chamberlain NL, Driver ED, Miesfeld RI. The length and location of CAG trinucleotide repeats in the androgen receptor N-terminal domain affect transactivation function. Nucleic Acids Res 1994;22:3181–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Lyon MF. The William Allan memorial award address: X-chromosome inactivation and the location and expression of X-linked genes. Am J Hum Genet 1988;42:8–16.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Racchi O, Mangerini R, Rapezzi D, Rolfo M, Gaetani GF, Ferraris AM. X chromosome inactivation patterns in normal females. Blood Cells Mol Dis 1998;24:439–47.

    Article  CAS  PubMed  Google Scholar 

  14. Fialkow PJ. Primordial cell pool size and lineage relationships of five human cell types. Ann Hum Genet 1973;37:39–48.

    Article  CAS  PubMed  Google Scholar 

  15. Busque L, Mio R, Mattioli J, et al. Nonrandom X-inactivation patterns in normal females: lyonization ratios vary with age. Blood 1996;88:59–65.

    Article  CAS  PubMed  Google Scholar 

  16. Hickey T, Chandy A, Norman RJ. The androgen receptor CAG repeat polymorphism and X-chromosome inactivation in Australian Caucasian women with infertility related to polycystic ovary syndrome. J Clin Endocrinol Metab 2002;87:161–5.

    Article  CAS  PubMed  Google Scholar 

  17. Westberg L, Baghaei F, Rosmond R, et al. Polymorphisms of the androgen receptor gene and the estrogen receptor beta gene are associated with androgen levels in women. J Clin Endocrinol Metab 2001;86:2562–8.

    CAS  PubMed  Google Scholar 

  18. Ibanez L, Ong KK, Mongan N, et al. Androgen receptor gene CAG repeat polymorphism in the development of ovarian hy-perandrogenism. J Clin Endocrinol Metab 2003;88:3333–8.

    Article  CAS  PubMed  Google Scholar 

  19. Joint National Committee. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med 1993;153:154–83.

    Article  Google Scholar 

  20. Spritzer PM, Poy M, Wiltgen D, Mylius LS, Capp E. Leptin concentrations in hirsute women with polycystic ovary syndrome or idiopathic hirsutism: Influence on LH and relationship with hormonal, metabolic, and anthropometric measurements. Hum Reprod 2001;16:1340–6.

    Article  CAS  PubMed  Google Scholar 

  21. Comim FV, Spritzer PM. Increased growth hormone response to Clonidine in nonobese normoinsulinemic patients with polycystic ovary syndrome. Fertil Steril 2004;81:108–13.

    Article  CAS  PubMed  Google Scholar 

  22. World Health Organization. Diabetes Mellitus: Report of a Study Group. Technical Report Series 727. Geneva: WHO, 1985.

    Google Scholar 

  23. Harris MI, Hadden WC, Knowler WC, Bennett PH. International criteria for the diagnosis of diabetes and impaired glucose tolerance. Diabetes Care 1985;8:562–7.

    Article  CAS  PubMed  Google Scholar 

  24. Van Pottelbergh I, Lumbroso S, Goemaere S, Sultan C, Kaufman JM. Lack of influence of the androgen receptor gene CAG-repeat polymorphism on sex steroid status and bone metabolism in elderly men. Clin Endocrinol (Oxf) 2001;55:659–66.

    Article  Google Scholar 

  25. Pegoraro E, Whitaker J, Mowery-Rushton P, Surti U, Lanasa M, Hoffman EP. Familial skewed X inactivation: A molecular trait associated with high spontaneous-abortion rate maps to Xq28. Am J Hum Genet 1997;61:160–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Allen RC, Zoghbi HY, Moseley AB, Rosenblatt HM, Belmont JW. Methylation of HpaII and HhaI sites near the polymorphic CAG repeat in the human androgen-receptor gene correlates with X chromosome inactivation. Am J Hum Genet 1992;51:1229–39.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Naumova AK, Plenge RM, Bird LM, et al. Heritability of X chromosome-inactivation phenotype in a large family. Am J Hum Genet 1996;58:1111–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Rossi R, Zatelli MC, Valentini A, et al. Evidence for androgen receptor gene expression and growth inhibitory effect of dihy-drotestosterone on human adrenocortical cells. J Endocrinol 1998;159:373–80.

    Article  CAS  PubMed  Google Scholar 

  29. Chadha S, Pache TD, Huikeshoven JM, Brinkmann AO, van der Kwast TH. Androgen receptor expression in human ovarian and uterine tissue of long-term androgen-treated transsexual women. Hum Pathol 1994;25:1198–204.

    Article  CAS  PubMed  Google Scholar 

  30. Liu PY, Death AK, Handelsman DJ. Androgens and cardiovascular disease. Endocr Rev 2003;24:313–40.

    Article  CAS  PubMed  Google Scholar 

  31. Kazemi-Esfarjani P, Trifiro MA, Pinsky I. Evidence for a repressive function of the long polyglutamine tract in the human androgen receptor: possible pathogenetic relevance for the (CAG)n-expanded neuronopathies. Hum Mol Genet 1995;4:523–7.

    Article  CAS  PubMed  Google Scholar 

  32. Irvine RA, Yu MC, Ross RK, Coetzee GA. The CAG and GGC microsatellites of the androgen receptor gene are in linkage disequilibrium in men with prostate cancer. Cancer Res 1995;55:1937–40.

    CAS  PubMed  Google Scholar 

  33. Nelson KA, Witte JS: Androgen receptor CAG repeats and prostate cancer. Am J Epidemiol 2002;155:883–90.

    Article  PubMed  Google Scholar 

  34. Zitzmann M, Brune M, Kornmann B, et al. The CAG repeat polymorphism in the AR gene affects high density lipoprotein cholesterol and arterial vasoreactivity. J Clin Endocrinol Metab 2001;86:4867–73.

    Article  CAS  PubMed  Google Scholar 

  35. Zitzmann M, Brune M, Kornmann B, Gromoll J, Junker R, Nieschlag E. The CAG repeat polymorphism in the androgen receptor gene affects bone density and bone metabolism in healthy males. Clin Endocrinol (Oxf) 2001;55:649–57.

    Article  CAS  Google Scholar 

  36. Sharp A, Robinson D, Jacobs P. Age- and tissue-specific variation of X chromosome inactivation ratios in normal women. Hum Genet 2000;107:343–9.

    Article  CAS  PubMed  Google Scholar 

  37. Puck JM, Willard HF. X inactivation in females with X-linked disease. N Engl J Med 1998;338:325–8.

    Article  CAS  PubMed  Google Scholar 

  38. Belmont JW. Genetic control of X inactivation and processes leading to X-inactivation skewing. Am J Hum Genet 1996;58:1101–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Kristiansen M, Langerod A, Knudsen GP, Weber BL, Borresen AL, Orstavik KH. High frequency of skewed X inactivation in young breast cancer patients. J Med Genet 2002;39:30–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Buller PJE, Sood AK, Lallas T, Buekers T, Skilling JS. Association between nonrandom X- chromosome inactivation and BRCA1 mutation in germline DNA of patients with ovarian cancer. J Natl Cancer Inst 1999;91:339–46.

    Article  CAS  PubMed  Google Scholar 

  41. Tonon L, Bergamaschi G, Dellavecchia C, et al. Unbalanced X-chromosome inactivation in haemopoietic cells from normal women. Br J Haematol 1998;102:996–1003.

    Article  CAS  PubMed  Google Scholar 

  42. Champion KM, Gilbert JG, Asimakopoulos FA, Hinshelwood S, Green AR: Clonal haemopoiesis in normal elderly women: Implications for the myeloproliferative disorders and myelodysplastic syndromes. Br J Haematol 1997;97:920–6.

    Article  CAS  PubMed  Google Scholar 

  43. Gale RE, Fielding AK, Harrison CN, Linch DC. Acquired skewing of X-chromosome inactivation patterns in myeloid cells of the elderly suggests stochastic clonal loss with age. Br J Haematol 1997;98:512–9.

    Article  CAS  PubMed  Google Scholar 

  44. Burger HG. Androgen production in women. Fertil Steril 2002; 77(Suppl 4):S3–5.

    Article  PubMed  Google Scholar 

  45. Skalba P, Wojtowicz M, Sikora J. Androgen and SHBG serum concentrations in late post- menopause women. Med Sci Monit 2003;9:CR152–6.

    CAS  PubMed  Google Scholar 

  46. Kaczmarek A, Reczuch K, Majda J, Banasiak W, Ponikowski P. The association of lower testosterone level with coronary artery disease in postmenopausal women. Int J Cardiol 2003;87:53–7.

    Article  PubMed  Google Scholar 

  47. Reinecke H, Bogdanski J, Woltering A, et al. Relation of serum levels of sex hormone binding globulin to coronary heart disease in postmenopausal women. Am J Cardiol 2002;90:364–8.

    Article  CAS  PubMed  Google Scholar 

  48. Maturana MA, Spritzer PM. Association between hyperinsulinemia and endogenous androgen levels in peri- and postmenopausal women. Metabolism 2002;51:238–43.

    Article  CAS  PubMed  Google Scholar 

  49. Kalish GM, Barrett-Connor E, Laughlin GA, Gulanski B. Association of endogenous sex hormones and insulin resistance among postmenopausal women: Results from the Postmenopausal Estrogen/Progestin Intervention Trial. J Clin Endocrinol Metab 2003;88:1646–52.

    Article  CAS  PubMed  Google Scholar 

  50. Zitzmann M, Nieschlag E. The CAG repeat polymorphism within the androgen receptor gene and maleness. Int J Androl 2003;26:76–83.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Ilma Simoni Brum MSc, PhD.

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Brum, I.S., Spritzer, P.M., Paris, F. et al. Association Between Androgen Receptor Gene CAG Repeat Polymorphism and Plasma Testosterone Levels in Postmenopausal Women. Reprod. Sci. 12, 135–141 (2005). https://doi.org/10.1016/j.jsgi.2004.11.003

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