Androgens and hyperemesis gravidarum: a case-control study.
OBJECTIVE
The pathogenesis of hyperemesis gravidarum (HG) is probably multifactorial, involving several hormones. Androgen concentrations are reported to correlate positively with emesis gravidarum. Hypothesizing a continuum between emesis gravidarum and HG, we investigated androgen concentrations in women with HG.


METHODS
In a case-control study, 32 women hospitalized for HG were compared with 29 control women scheduled for elective surgical abortion. Control women were matched for age, gestational length, body mass index (BMI) and parity. Patient characteristics and concentrations of dehydroepiandrosterone sulphate (DHEAS), androstenedione, testosterone, sex hormone binding globulin (SHBG), free testosterone index (FTI), androstanediol glucuronide (ADG), progesterone, TSH, free T3 and T4, beta-hCG, ferritin, insulin, estradiol and estriol were compared using Mann-Whitney tests and multivariate linear regression analyses.


RESULTS
Women with HG had higher concentrations of ADG (8.49±4.19 vs. 6.19±1.77pmol/L; p=0.015), estradiol (2.39±1.36 vs. 1.60±9.30nmol/L; p=0.009) and ferritin (186±138 vs. 117±94pmol/L; p=0.040) compared with control women. Androstenedione (5.34±2.82 vs. 6.86±2.67; p=0.004) and insulin (63.7±35.0 vs. 75.3±25.8; p=0.050) concentrations were lower in women with HG. DHEAS, testosterone, FTI, SHBG, estriol, progesterone, beta-hCG, TSH, free T3 and free T4 concentrations did not differ between the groups. In multivariate regression analyses HG was associated with high concentrations of ADG (p=0.026) and low concentrations of androstenedione (p=0.018).


CONCLUSIONS
Steroid hormone homeostasis may be altered in women with HG. HG may be associated with high ADG and low androstenedione concentrations.
Department of Internal Medicine, Drammen Hospital, Vestre Viken, 3004 Drammen, Norway. Electronic address: ragnhild.helseth@gmail.com.
Ragnhild
R
Helseth
Department of Obstetrics and Gynecology, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway.
Merethe
M
Ravlo
Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway; Department of Endocrinology, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway.
Sven M
SM
Carlsen
Department of Obstetrics and Gynecology, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7489 Trondheim, Norway.
E Eszter
EE
Vanky
D000328:Adult; D000728:Androgens / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000097:blood*; D016014:Linear Models; D011247:Pregnancy; D055815:Young Adult
D000728:Androgens
Androgens; Hormones; Hyperemesis gravidarum; Thyroid; beta-hCG