title: Variants in SULT2A1 affect the DHEA sulphate to DHEA ratio in patients with polycystic ovary syndrome but not the hyperandrogenic phenotype.
abstract: BACKGROUND
  Because of the elevated dehydroepiandrosterone sulfate (DHEAS) levels in polycystic ovary syndrome (PCOS) and the heritability of DHEAS serum levels, genes encoding the enzymes that control the sulfation of dehydroepiandrosterone (DHEA) to DHEAS and vice versa are obvious candidate genes to explain part of the heritability of PCOS.
  
  
  OBJECTIVE
  The objective of the study was to determine the role of genetic variants in sulfotransferase (SULT2A1), 3-phosphoadenosine 5-phosphosulfate synthase isoform 2 (PAPSS2), and steroid sulfatase (STS) in PCOS and in hormone levels related to the hyperandrogenic phenotype of PCOS.
  
  
  METHODS
  This was a candidate-gene study.
  
  
  METHODS
  The discovery set consisted of 582 patients and 2017 controls.
  
  
  METHODS
  A pruned subset of 28 single-nucleotide polymorphisms (SNPs) in SULT2A1, PAPSS2, and STS was generated based on pairwise genotypic correlation. Association with PCOS was tested, and we studied whether the SNPs modulate DHEAS levels, DHEA levels, and their ratio in PCOS. Significant SNPs were replicated in an independent sample of patients.
  
  
  RESULTS
  None of the SNPs in SULT2A1, PAPSS2, and STS constituted risk alleles for PCOS. SNP rs2910397 in SULT2A1 decreased the DHEAS to DHEA ratio in PCOS by 5% in the discovery sample. Meta-analysis of discovery and replication sample resulted in a combined effect of -0.095 (P = .027). However, carrying the minor T allele did not contribute to differences in the hyperandrogenic phenotype, including the levels of T and androstenedione, of PCOS patients.
  
  
  CONCLUSIONS
  Genetic variants in SULT2A1, PAPSS2, and STS do not predispose to PCOS. Although a variant in SULT2A1 decreased the DHEAS to DHEA ratio, no changes in other androgenic hormone levels were observed.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands. y.louwers@erasmusmc.nl
authors.forename: Yvonne V
authors.initials: YV
authors.lastname: Louwers
authors.forename: Frank H
authors.initials: FH
authors.lastname: de Jong
authors.forename: Nathalie A A
authors.initials: NA
authors.lastname: van Herwaarden
authors.forename: Lisette
authors.initials: L
authors.lastname: Stolk
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
authors.forename: André G
authors.initials: AG
authors.lastname: Uitterlinden
authors.forename: Joop S E
authors.initials: JS
authors.lastname: Laven
mesh_terms: D000328:Adult; D000483:Alleles; D003687:Dehydroepiandrosterone / Q000097:blood*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000235:genetics; D009097:Multienzyme Complexes / Q000235:genetics; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D043266:Steryl-Sulfatase / Q000235:genetics; D013430:Sulfate Adenylyltransferase / Q000235:genetics; D015238:Sulfotransferases / Q000235:genetics*
chemical_list: D009097:Multienzyme Complexes; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; C022322:PAPS synthetase; D013430:Sulfate Adenylyltransferase; D015238:Sulfotransferases; C028152:alcohol sulfotransferase; D043266:Steryl-Sulfatase