title: Atypical polycystic ovary syndrome--a genetic analysis.
abstract: OBJECTIVE
  Although polycystic ovary syndrome (PCOS) is a common endocrinopathy the pathogenesis is not entirely understood. Typically, high androgen levels are associated with increased virilization. We report 2 rare groups of patients with either unexpectedly high testosterone levels despite low virilization as well as patients with low testosterone levels despite high grade of virilization. One possibility for the atypical PCOS may be based on an altered androgen receptor (AR) signaling.
  
  
  METHODS
  6 patients and when available the parents were included in this study. Alterations of the metaphase chromosomes by GTG staining, the length of both the trinucleotide CAG- and GGC-repeats of the androgen receptor (AR) gene was determined by PCR, further the entire AR gene was sequenced and analyzed.
  
  
  RESULTS
  The GTG banding revealed no chromosomal alterations and the range of CAG- and GGC-repeat lengths are within the normal range. Interestingly, by sequencing of the entire AR gene few genetic mutations were identified.
  
  
  CONCLUSIONS
  The detected mutations do not alter the AR protein sequence but they change the codon usage towards less frequent codons that potentially may alter AR protein levels and androgen signaling. In addition to this, we postulate also other causes for manifestation of atypical PCOS, which may include AR-coregulators or epigenetic alterations. To our knowledge this is the first report of combining chromosomal analysis of PCOS patients with full sequencing of the human AR gene and linking codon usage to PCOS.
authors.affiliation: Department of Pediatrics, Jena University Hospital, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Scholten
authors.affiliation: Department of Pediatrics, Jena University Hospital, Jena, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Vilser
authors.affiliation: Institute of Human Genetics, Jena University Hospital, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Weise
authors.affiliation: Institute of Human Genetics, Jena University Hospital, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Baniahmad
mesh_terms: D000293:Adolescent; D002648:Child; D003062:Codon / Q000235:genetics*; D044127:Epigenesis, Genetic; D005260:Female; D006801:Humans; D009154:Mutation; D011085:Polycystic Ovary Syndrome / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D011944:Receptors, Androgen / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction / Q000235:genetics; D018911:Trinucleotide Repeats
chemical_list: D003062:Codon; D011944:Receptors, Androgen