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ANDROSTERONE GLUCURONIDE IS A MARKER OF ADRENAL HYPERANDROGENISM IN HIRSUTE WOMEN
Author(s) -
THOMPSON DAVID L.,
HORTON NATALIE,
RITTMASTER ROGER S.
Publication year - 1990
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1990.tb00868.x
Subject(s) - androsterone , hirsutism , medicine , endocrinology , hyperandrogenism , polycystic ovary , androstenedione , androgen , obesity , steroid , insulin resistance , hormone
SUMMARY Androsterone glucuronide (Andros‐G), a dihydrotestosterone metabolite, is present in serum at concentrations at least tenfold greater than those of androstanediol glucuronide. To investigate the significance of serum androsterone glucuronide, we developed a direct radioimmunoassay for this compound and measured its levels in normal women, women with mild or severe idiopathic hirsutism (IH), hirsute women with polycystic ovarian syndrome (PCO), and non‐hirsute obese women. To determine the source of Andros‐G precursors, serum levels were measured before and after selective ovarian suppression with leuprolide, combined ovarian and adrenal suppression with leuprolide and dexamethasone, and adrenal stimulation with ACTH. Androsterone glucuronide levels (nmol/l; mean±SD) were significantly higher (P < 0.025) in women with mild idiopathic hirsutism (IH) (185±91), severe IH (173±97), and hirsute women with polycystic ovarian syndrome (PCO) (178±102) than in normal women (110±26). Levels in non‐hirsute obese women (64±19) were lower than in normal women (P <0.01). Baseline levels (mean±SEM) in hirsute women given 20 μg/kg/day leuprolide for 5‐9 months (171±15) were not significantly changed after leuprolide alone (153±18), and were decreased after adding dexamethasone (19±6; P < 0.001). Andros‐G levels did not increase significantly in normal women 60 min after i.v. ACTH (112±14 to 126±19), but rose in IH (170±24 to 216±26; P<0.001) and in PCO (179±26 to 238±31; P= 0002). We conclude that Andros‐G in women arises primarily from adrenal gland precursors and is elevated in hirsute women as a group. Its levels do not correlate with the severity of hirsutism, or the presence or absence of PCO, but reflect an increased production of adrenal androgens in both IH and PCO.