title: Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS).
abstract: BACKGROUND
  Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS.
  
  
  METHODS
  We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth- generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA.
  
  
  RESULTS
  cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-to-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-the-receiver-operating-characteristic curve of 0.89.
  
  
  CONCLUSIONS
  Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.
authors.affiliation: .
authors.forename: Eleftherios P
authors.initials: EP
authors.lastname: Diamandis
authors.affiliation: .
authors.forename: Frank Z
authors.initials: FZ
authors.lastname: Stanczyk
authors.affiliation: .
authors.forename: Sarah
authors.initials: S
authors.lastname: Wheeler
authors.affiliation: .
authors.forename: Anu
authors.initials: A
authors.lastname: Mathew
authors.affiliation: .
authors.forename: Martin
authors.initials: M
authors.lastname: Stengelin
authors.affiliation: .
authors.forename: Galina
authors.initials: G
authors.lastname: Nikolenko
authors.affiliation: .
authors.forename: Eli N
authors.initials: EN
authors.lastname: Glezer
authors.affiliation: .
authors.forename: Marshall D
authors.initials: MD
authors.lastname: Brown
authors.affiliation: .
authors.forename: Yingye
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: .
authors.forename: Yen-Hao
authors.initials: YH
authors.lastname: Chen
authors.affiliation: .
authors.forename: Hsiao-Li
authors.initials: HL
authors.lastname: Wu
authors.affiliation: .
authors.forename: Ricardo
authors.initials: R
authors.lastname: Azziz
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007118:Immunoassay; D008163:Luminescent Measurements; D015999:Multivariate Analysis; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis*; D017430:Prostate-Specific Antigen / Q000097:blood*; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic
chemical_list: D015415:Biomarkers; D011933:Reagent Kits, Diagnostic; D017430:Prostate-Specific Antigen
keywords: androgen-regulated genes; hirsutism; hyperandrogenism; polycystic ovarian syndrome; prostate specific antigen; serum biomarkers; urine biomarkers