title: Are there any sensitive and specific sex steroid markers for polycystic ovary syndrome?
abstract: BACKGROUND
  Despite the high prevalence of hyperandrogenemia, the principal biochemical abnormality in women with polycystic ovary syndrome (PCOS), a definitive endocrine marker for PCOS has so far not been identified.
  
  
  OBJECTIVE
  To identify a tentative diagnostic marker for PCOS, we compared serum levels of sex steroids, their precursors, and main metabolites in women with PCOS and controls.
  
  
  METHODS
  In this cross-sectional study of 74 women with PCOS and 31 controls, we used gas and liquid chromatography/mass spectrometry to analyze serum sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites; performed immunoassays of SHBG, LH, and FSH; and calculated the LH/FSH ratio.
  
  
  RESULTS
  Androgens and estrogens, sex steroid precursors, and glucuronidated androgen metabolites were higher in women with PCOS than in controls. In multivariate logistic regression analyses, estrone and free testosterone were independently associated with PCOS. The odds ratios per sd increase were 24.2 for estrone [95% confidence interval (CI), 4.0-144.7] and 12.8 for free testosterone (95% CI, 3.1-53.4). In receiver operating characteristic analyses, the area under curve was 0.93 for estrone (95% CI, 0.88-0.98) and 0.91 for free testosterone (95% CI, 0.86-0.97), indicating high sensitivity and specificity.
  
  
  CONCLUSIONS
  Women with PCOS have elevated levels of sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites as measured with a specific and sensitive mass spectrometry-based technique. The combination of elevated estrone (>50 pg/ml) and free testosterone (>3.3 pg/ml) appeared to discriminate with high sensitivity and specificity between women with and without PCOS.
authors.affiliation: Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Box 434, 40530 Göteborg, Sweden. elisabet.stener-victorin@neuro.gu.se
authors.forename: Elisabet
authors.initials: E
authors.lastname: Stener-Victorin
authors.forename: Göran
authors.initials: G
authors.lastname: Holm
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Lars
authors.initials: L
authors.lastname: Nilsson
authors.forename: Per Olof
authors.initials: PO
authors.lastname: Janson
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D012739:Gonadal Steroid Hormones; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone