title: 5α-reductase activity in women with polycystic ovary syndrome: a systematic review and meta-analysis.
abstract: BACKGROUND
  5α-reductase activity might be important during the development of polycystic ovary syndrome (PCOS). However, the changes of 5α-reductase activity in PCOS subjects and the relationship between 5α-reductase activity and body mass index (BMI), insulin resistance (IR) remain largely unknown.
  
  
  METHODS
  We performed a meta-analysis to examine 5α-reductase activity in women with PCOS; exploratory subgroup analyses were also performed.
  
  
  RESULTS
  Five articles (with 356 cases and 236 controls) reporting 5α-reductase activity in patients with PCOS were selected for the meta-analysis. We observed significantly higher ratios of 5αTHF/THF (5α-reduced tetrahydrocortisol to 5β-reduced tetrahydrocortisol) and An/Et (androsteroneto/etiocholanolone) levels, which were used to assess 5α-reductase activity, among the patients with PCOS, [standardized mean differences (SMD) =0.43, 95%confidence intervals (95%CI) =0.25-0.61, P < 0.00001; SMD = 0.86, 95% CI = 0.29-1.44, P = 0.003]. We observed significant heterogeneity between studies for An/Et (I2= 89% and P < 0.00001). According to the group analysis, women with PCOS exhibited increased 5α-reductase activity which was significantly associated with homeostasis model assessment of insulin resistance (HOMA-IR) regardless of obesity.
  
  
  CONCLUSIONS
  5α-reductase activity was enhanced in women with PCOS. Increased 5α-reductase activity in patients with PCOS was related to IR.
authors.affiliation: Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Chuyan
authors.initials: C
authors.lastname: Wu
authors.affiliation: Medical Service Section, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Wei
authors.affiliation: Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China. jiangzh3721@163.com.
authors.forename: Zhongli
authors.initials: Z
authors.lastname: Jiang
mesh_terms: D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase / Q000378:metabolism; D015992:Body Mass Index; D042944:Cholestenone 5 alpha-Reductase / Q000378:metabolism*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008565:Membrane Proteins / Q000378:metabolism; D009765:Obesity / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000201:enzymology* / Q000503:physiopathology
chemical_list: D008565:Membrane Proteins; D042944:Cholestenone 5 alpha-Reductase; D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase; C548467:SRD5A1 protein, human; C548468:SRD5A2 protein, human
keywords: 5α-Reductase; Body mass index; Insulin resistance; Polycystic ovary syndrome