title: Comparison of steroidogenic pathways among normoandrogenic and hyperandrogenic polycystic ovary syndrome patients and normal cycling women.
abstract: OBJECTIVE
  To compare the corticosteroidogenic enzyme activities between normal cycling non-polycystic ovary syndrome (PCOS), and normoandrogenic PCOS (NA-PCOS) and hyperandrogenic PCOS (HA-PCOS) patients.
  
  
  METHODS
  This cohort study was conducted at Julio Muller University Hospital and Tropical Institute of Reproductive Medicine and Menopause, and enrolled 114 non-PCOS women and 355 PCOS patients. The steroidogenic enzyme activities were measured using the serum steroid product/precursor molar ratio.
  
  
  RESULTS
  In the Δ5 pathway the 17,20 lyase activity was equally low in the NA-PCOS and HA-PCOS women compared with the non-PCOS women (P < 0.01 and P < 0.001, respectively). In the Δ4 pathway, the 17,20 lyase activity was higher only in the HA-PCOS group (P < 0.001). The 17-hydroxylase activity was the same in PCOS and non-PCOS subjects (P > 0.05). The 3β-hydroxysteroid dehydrogenase II (3β-HSDII) activity was higher in the conversion of dehydroepiandrosterone into androstenedione in the HA-PCOS than in the NA-PCOS (P < 0.05) and the non-PCOS patients (P < 0.01). The aromatase activity was lower in the HA-PCOS than in the NA-PCOS (P < 0.05) patients and non-PCOS subjects (P < 0.01). In HA-PCOS subjects, the 17,20 lyase activity was related to insulin, estradiol, total testosterone concentrations and free androgen index in the Δ5 pathway. 3β-HSDII showed weak correlation with estradiol in the HA-PCOS group. Anthropometric parameters had little impact, if any, on the steroidogenic enzyme activities.
  
  
  CONCLUSIONS
  The NA-PCOS and HA-PCOS patients demonstrated different enzyme activities, and the results provided new directions for future studies including PCOS patients with different phenotypes.
authors.affiliation: Department of Obstetrics and Gynecology, Medical Science School - UFMT, Cuiabá, Mato Grosso, Brazil; Julio Muller University Hospital, Cuiabá, Mato Grosso, Brazil; Tropical Institute of Reproductive Medicine and Menopause, Cuiabá, Mato Grosso, Brazil.
authors.forename: Sebastião Freitas de
authors.initials: SF
authors.lastname: Medeiros
authors.forename: Jacklyne Silva
authors.initials: JS
authors.lastname: Barbosa
authors.forename: Márcia Marly Winck
authors.initials: MM
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000378:metabolism; D016022:Case-Control Studies; D003687:Dehydroepiandrosterone / Q000378:metabolism; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000201:enzymology*; D007328:Insulin / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000201:enzymology*; D011375:Progesterone Reductase / Q000378:metabolism*; D015398:Signal Transduction; D013254:Steroid 17-alpha-Hydroxylase / Q000378:metabolism*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D000728:Androgens; D007328:Insulin; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D004958:Estradiol; C533068:3 beta-hydroxysteroid dehydrogenase type II; D011375:Progesterone Reductase; D013254:Steroid 17-alpha-Hydroxylase
keywords: adrenal stimulation; enzyme activity; hyperandrogenism; polycystic ovary syndrome; steroidogenesis