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Comparison of steroidogenic pathways among normoandrogenic and hyperandrogenic polycystic ovary syndrome patients and normal cycling women
Author(s) -
Medeiros Sebastião Freitas,
Barbosa Jacklyne Silva,
Yamamoto Márcia Marly Winck
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12524
Subject(s) - polycystic ovary , medicine , endocrinology , androstenedione , hirsutism , testosterone (patch) , hyperandrogenism , dehydroepiandrosterone , aromatase , androgen , insulin , insulin resistance , hormone , breast cancer , cancer
Aim To compare the corticosteroidogenic enzyme activities between normal cycling non‐polycystic ovary syndrome ( PCOS ), and normoandrogenic PCOS ( NA ‐ PCOS ) and hyperandrogenic PCOS ( HA‐PCOS ) patients. Methods This cohort study was conducted at J ulio M uller U niversity H ospital and T ropical I nstitute of R eproductive M edicine and M enopause, and enrolled 114 non‐ PCOS women and 355 PCOS patients. The steroidogenic enzyme activities were measured using the serum steroid product/precursor molar ratio. Results In the Δ5 pathway the 17,20 lyase activity was equally low in the NA‐PCOS and HA‐PCOS women compared with the non‐ PCOS women ( P < 0.01 and P < 0.001, respectively). In the Δ4 pathway, the 17,20 lyase activity was higher only in the HA‐PCOS group ( P < 0.001). The 17‐hydroxylase activity was the same in PCOS and non‐ PCOS subjects ( P > 0.05). The 3β‐hydroxysteroid dehydrogenase II (3β‐ HSDII ) activity was higher in the conversion of dehydroepiandrosterone into androstenedione in the HA‐PCOS than in the NA‐PCOS ( P < 0.05) and the non‐ PCOS patients ( P < 0.01). The aromatase activity was lower in the HA‐PCOS than in the NA‐PCOS ( P < 0.05) patients and non‐ PCOS subjects ( P < 0.01). In HA‐PCOS subjects, the 17,20 lyase activity was related to insulin, estradiol, total testosterone concentrations and free androgen index in the Δ5 pathway. 3β‐ HSDII showed weak correlation with estradiol in the HA‐PCOS group. Anthropometric parameters had little impact, if any, on the steroidogenic enzyme activities. Conclusion The NA‐PCOS and HA‐PCOS patients demonstrated different enzyme activities, and the results provided new directions for future studies including PCOS patients with different phenotypes.