title: Opposing effects of dehydroepiandrosterone sulfate and free testosterone on metabolic phenotype in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To study the association of adrenal and ovarian androgen levels with metabolic parameters in a large cohort of women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Outpatient clinic of an academic hospital.
  
  
  METHODS
  Six hundred twenty-two women with PCOS.
  
  
  METHODS
  None.
  
  
  METHODS
  Analysis of the association of endocrine dehydroepiandrosterone sulfate (DHEAS) and free testosterone (FT) parameters with metabolic measurements.
  
  
  RESULTS
  In multivariate adjusted logistic regression analyses, the odds ratio (OR) for insulin resistance was statistically significantly higher (4.42, range: 2.26-8.67) for women with PCOS who had elevated FT levels compared with the women with normal DHEAS and FT levels (reference group). We found no statistically significant differences when women with PCOS with elevated DHEAS or a combined elevation of DHEAS and FT levels were compared with the reference group. Women with PCOS and a high DHEAS/FT ratio had a more beneficial metabolic profile compared with the women with a low DHEAS/FT ratio. In multivariate adjusted binary logistic regression analyses, we found a statistically significantly lower risk for insulin resistance in the women with PCOS in the highest DHEAS/FT-ratio quartile compared with women with PCOS in the lowest quartile (OR 0.35, range: 0.14-0.89).
  
  
  CONCLUSIONS
  Our results suggest that the distinction between adrenal and ovarian hyperandrogenism is important when evaluating metabolic risk in PCOS.
authors: Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria. elisabeth.lerchbaum@medunigraz.at
authors: Elisabeth
authors: E
authors: Lerchbaum
authors: Verena
authors: V
authors: Schwetz
authors: Albrecht
authors: A
authors: Giuliani
authors: Thomas R
authors: TR
authors: Pieber
authors: Barbara
authors: B
authors: Obermayer-Pietsch
mesh_terms: D000311:Adrenal Glands / Q000378:metabolism*; D000328:Adult; D001317:Austria; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood / Q000378:metabolism*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D007333:Insulin Resistance; D016014:Linear Models; D016015:Logistic Models; D008659:Metabolic Diseases / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010053:Ovary / Q000000981:diagnostic imaging / Q000378:metabolism*; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D018570:Risk Assessment; D012307:Risk Factors; D013739:Testosterone / Q000097:blood / Q000378:metabolism*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate