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Serum androgen levels elevated in PCOS even after menopause
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Elevated serum androgen levels, even after menopause, are found in women with polycystic ovary syndrome, although these levels decline somewhat with age, according to recent study finding published in The Journal of Endocrinology & Metabolism.
According to the researchers, PCOS was best predicted with calculated free testosterone, androstenedione and free androgen index.
Laure Morin-Papunen, MD, of Oulu University Hospital in Finland, and colleagues evaluated 681 women with PCOS and 230 healthy referent women from five university sites in the Nordic countries to determine the effect of age on serum androgen levels and the cutoff values for androgens and sex hormone-binding globulin related to a diagnosis of PCOS. Participants were divided into groups based on age: 18 to 24 years, 25 to 29 years, 30 to 34 years, 35 to 39 years, 40 to 44 years, 45 to 49 years and 50 years or older.
Main outcome measures included testosterone, SHBG, free androgen index, calculated free testosterone, androstenedione and dehydroepiandrosterone sulfate. Compared with the healthy group, the PCOS group had higher testosterone concentrations in the first four age groups (from 18 to 39 years; P < .001), which remained after adjustment for BMI (P ≤ .001). All age groups of the PCOS group had lower serum SHBG except for those aged 45 to 49 years. The PCOS group had higher levels of free androgen index and calculated free testosterone at age 18 to 44 years and age 50 years and older. The significance remained after adjusting for BMI in the group aged 18 to 44 years, but not in the group aged 30 to 34 years for free androgen index.
In participants aged 18 to 34 years and older than 50 years, serum levels of androstenedione were significantly higher in the PCOS group compared with the healthy group; this remained after adjustment for BMI. Higher serum DHEA sulfate levels were found in the PCOS group for those aged 25 to 29 years and older than 50 years after adjustment for BMI. The healthy group aged 40 to 44 years had higher levels of DHEA sulfate compared with the PCOS group, but this was not significant after adjustment for BMI.
Calculated free testosterone (≥ 0.4 ng/dL; OR = 7.9), free androgen index (≥ 2; OR = 6.71) and androstenedione (≥ 277.94 ng/dL; OR = 6.16) were the greatest predictive factors for PCOS.
“This Nordic multicenter collaboration study shows that women with PCOS are more obese and have higher serum androgen levels throughout reproductive life than healthy reference women,” the researchers wrote. “Hyperandrogenemia improves with age toward menopause in women with PCOS, but remains elevated after menopause. According to the logistic regression analysis, [calculated free testosterone], the [free androgen index] and serum [androstenedione] are the best discriminators of PCOS at all ages and may be used as additional tools for diagnosing PCOS. Lastly, in this population, the use of [calculated free testosterone] instead of the [free androgen index] as a discriminator of PCOS seems to be more accurate in women under 40 years of age, at least when using [liquid chromatography-tandem mass spectrometry] for assay of [testosterone].” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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