title: Ovarian and adrenal androgens and their link to high human chorionic gonadotropin levels: a prospective controlled study.
abstract: Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r = 0.78; P ≤ 0.001, r = 0.74;  P ≤ 0.001, and r = 0.71;  P ≤ 0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P = 0.001) and free T and DHEA-S declined significantly (P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: René
authors.initials: R
authors.lastname: Rodríguez-Gutiérrez
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Jesús Zacarías
authors.initials: JZ
authors.lastname: Villarreal-Pérez
authors.affiliation: Obstetrics and Gynecology Department, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Felipe Arturo
authors.initials: FA
authors.lastname: Morales-Martinez
authors.affiliation: Obstetrics and Gynecology Department, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: René
authors.initials: R
authors.lastname: Rodríguez-Guajardo
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Gloria
authors.initials: G
authors.lastname: González-Saldivar
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Leonardo G
authors.initials: LG
authors.lastname: Mancillas-Adame
authors.affiliation: Clinical Research Unit, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Neri Alejandro
authors.initials: NA
authors.lastname: Alvarez-Villalobos
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: Fernando Javier
authors.initials: FJ
authors.lastname: Lavalle-Gonzalez
authors.affiliation: Endocrinology Division, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico ; Clinical Research Unit, University Hospital "Dr. José E. González", School of Medicine, Autonomous University of Nuevo León, Francisco I. Madero and Gonzalitos s/n, 64460 Monterrey, NL, Mexico.
authors.forename: José Gerardo
authors.initials: JG
authors.lastname: González-González