title: New insights into steroidogenesis in normo- and hyperandrogenic polycystic ovary syndrome patients.
abstract: OBJECTIVE
  This study sought to examine corticosteroidogenic enzyme activities in normo- and hyperandrogenic polycystic ovary syndrome (PCOS) patients.
  
  
  METHODS
  This cohort study included 81 patients with biochemical hyperandrogenism and 41 patients with normal androgen levels. Enzyme activities were assessed according to the serum steroid product/precursor ratios at baseline and after adrenal stimulation.
  
  
  RESULTS
  At baseline, in the delta 4 (Δ4) pathway, hyperandrogenic patients showed greater 17-hydroxylase and 17,20 lyase activities in converting progesterone (P4) into 17-hydroxyprogesterone (17-OHP4) and 17-hydroxypregnenolone (17-OHPE) into androstenedione (A) (p = 0.0005 and p = 0.047, respectively) compared to normoandrogenic patients. In the delta 5 (Δ5) pathway, the 17-hydroxylase and 17,20 lyase enzymes showed similar activities in both groups. Hyperandrogenic patients presented lower 21-hydroxylase, lower 11β-hydroxylase (p = 0.0001), and statistically significant increases in 3β-hydroxysteroid dehydrogenase II (3β-HSDII) activities (p < 0.0001). Following tetracosactrin stimulation, only the 17,20 lyase activity remained up-regulated in the Δ4 pathway (p < 0.0001).
  
  
  CONCLUSIONS
  Hyperandrogenic patients had higher 17,20 lyase activity, both at baseline and after adrenal stimulation. Greater conversion of dehydroepiandrosterone (DHEA) into A with normal conversion of 17-OHPE to 17-OHP4 in hyperandrogenic PCOS patients indicated different levels of 3β-HSDII activity in adrenal cells, and hyperandrogenic patients had lower 11β-hydroxylase and 21-hydroxylase activities.
authors.forename: Sebastião Freitas de
authors.initials: SF
authors.lastname: Medeiros
authors.forename: Angelo Barrionuevo
authors.initials: AB
authors.lastname: Gil-Junior
authors.forename: Jacklyne Silva
authors.initials: JS
authors.lastname: Barbosa
authors.forename: Erico Duarte
authors.initials: ED
authors.lastname: Isaías
authors.forename: Márcia Marly Winck
authors.initials: MM
authors.lastname: Yamamoto
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000378:metabolism; D000311:Adrenal Glands / Q000201:enzymology*; D000312:Adrenal Hyperplasia, Congenital / Q000201:enzymology; D000328:Adult; D016022:Case-Control Studies; D003687:Dehydroepiandrosterone / Q000378:metabolism; D004789:Enzyme Activation; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000201:enzymology*; D008190:Lyases / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000201:enzymology*; D013252:Steroid 11-beta-Hydroxylase / Q000378:metabolism; D013254:Steroid 17-alpha-Hydroxylase / Q000378:metabolism; D013255:Steroid 21-Hydroxylase / Q000378:metabolism; D013250:Steroid Hydroxylases / Q000378:metabolism*
chemical_list: D003687:Dehydroepiandrosterone; D019326:17-alpha-Hydroxyprogesterone; D013250:Steroid Hydroxylases; D013255:Steroid 21-Hydroxylase; D013254:Steroid 17-alpha-Hydroxylase; D013252:Steroid 11-beta-Hydroxylase; D008190:Lyases