Elevated serum androstenedione is associated with a more severe phenotype in women with polycystic ovary syndrome (PCOS).
OBJECTIVE
To evaluate the impact of elevated serum Δ4A levels on the hormonal and metabolic features of the different phenotypes of PCOS.


METHODS
1276 women with PCOS according to the Rotterdam criteria were included, in whom serum hormonal levels were determined.


RESULTS
In PCOS women as a whole, as well as in patients presenting clinical and/or biochemical hyperandrogenemia (phenotypes I and II), Δ4A levels >3.8 ng/ml were positively related to LH, LH/FSH ratio, T, DHEAS, 17 OH progesterone and FAI and negatively related to T/Δ4A ratio. In the milder phenotype III, a positive correlation between Δ4A levels >3.8 ng/ml and T, DHEAS, 17 OH progesterone and FAI and a negative one between increased Δ4A and T/Δ4A ratio were reported. In the whole PCOS group with androstenedione >3.8 ng/ml, an increased ovarian volume was observed, while a greater mean follicular number was found only in phenotypes I and II.


CONCLUSIONS
Increased serum Δ4A levels, which are associated with more severe PCOS phenotypes, possibly contribute to the worsening of PCOS features and therefore could be a valuable marker of biochemical hyperandrogenemia.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology; University of Patras Medical School; Patras (N.A.G., A.K.A., N.D.R); Greece.
Neoklis A
NA
Georgopoulos
Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology; Aristotle University of Thessaloniki; Thessaloniki (E.P., I.K., D.P.); Greece.
Efstathios
E
Papadakis
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology; University of Patras Medical School; Patras (N.A.G., A.K.A., N.D.R); Greece.
Anastasia K
AK
Armeni
Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology; Aristotle University of Thessaloniki; Thessaloniki (E.P., I.K., D.P.); Greece.
Ilias
I
Katsikis
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology; University of Patras Medical School; Patras (N.A.G., A.K.A., N.D.R); Greece.
Nikolaos D
ND
Roupas
Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology; Aristotle University of Thessaloniki; Thessaloniki (E.P., I.K., D.P.); Greece.
Dimitrios
D
Panidis
D000735:Androstenedione / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D007333:Insulin Resistance; D016014:Linear Models; D015999:Multivariate Analysis; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000378:metabolism; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D014463:Ultrasonography; D015854:Up-Regulation
D015415:Biomarkers; D000735:Androstenedione