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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(02): 142-153
DOI: 10.1055/s-0041-1741030
Original Article
Gynecological Endocrinology

Adrenal Androgen Predictive Effects on Clinical and Metabolic Abnormalities of Polycystic Ovary Syndrome

Efeitos preditivos dos androgênios adrenais nas anormalidades clínicas e metabólicas da síndrome dos ovários policísticos
Sebastião Freitas de Medeiros 
1   Department of Gynecology and Obstetrics, Medical School, Universidade Federal do Mato Grosso, Cuiabá, MT, Brazil
2   Instituto Tropical de Medicina Reprodutiva, Cuiabá, MT, Brazil
,
Bruna Barcelo Barbosa 
2   Instituto Tropical de Medicina Reprodutiva, Cuiabá, MT, Brazil
,
Matheus Antônio Souto de Medeiros 
2   Instituto Tropical de Medicina Reprodutiva, Cuiabá, MT, Brazil
,
Ana Karine Lin Winck Yamamoto 
3   Universidade de Cuiabá, Cuiabá, MT, Brazil
,
Márcia Marly Winck Yamamoto 
2   Instituto Tropical de Medicina Reprodutiva, Cuiabá, MT, Brazil
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Abstract

Objective To examine the possible effects of adrenal prohormones in the prediction of clinical and metabolic abnormalities in women with polycystic ovary syndrome (PCOS).

Methods The present study enrolled 299 normal cycling non-PCOS, 156 normoandrogenemic, and 474 hyperandrogenemic women with PCOS. Baseline characteristics were compared using a chi-squared test or analysis of variance (ANOVA) as appropriate. The roles of adrenal prohormones and their ratios with total testosterone in predicting co-occurring morbidities in women PCOS were evaluated using univariate and multivariate logistic regression analyses.

Results Adrenal hyperandrogenism per dehydroepiandrosterone sulfate (DHEAS) levels were found in 32% of women with PCOS. In non-PCOS women, dehydroepiandrosterone (DHEA) and its sulfate had no predictive role concerning clinical, anthropometric, and metabolic parameters. In PCOS women, mainly in the hyperandrogenemic group, DHEA showed to be a significant predictor against most anthropometric-metabolic index abnormalities (odds ratio [OR] = 0.36–0.97; p < 0.05), and an increase in triglycerides (TG) levels (OR = 0.76; p = 0.006). Dehydroepiandrosterone sulfate presented a few predictive effects regarding PCOS-associated disorders. In controls, DHEAS predicted against the increase in estimated average glucose (OR= 0.38; p = 0.036). In the normoandrogenic group, it predicted against elevation in the waist/hip ratio (WHR) (OR= 0.59; p = 0.042), and in hyperandrogenemic PCOS women, it predicted against abnormality in the conicity index (CI) (OR = 0.31; p = 0.028).

Conclusion Dehydroepiandrosterone was shown to be a better predictor of abnormal anthropometric and biochemical parameters in women with PCOS than DHEAS. Thus, regarding adrenal prohormones, DHEA measurement, instead of DHEAS, should be preferred in PCOS management. The effects of androgen prohormones on the prediction of PCOS abnormalities are weak.

Resumo

Objetivo Examinar os possíveis efeitos dos pró-hormônios adrenais na predição de alterações clínicas e metabólicas em mulheres com síndrome dos ovários policísticos (SOP).

Métodos O presente estudo envolveu 299 mulheres com ciclos menstruais regulares e 630 mulheres com SOP, sendo 156 normoandrogenêmicas e 474 hiperandrogenêmicas. As variáveis incluídas como objeto do estudo foram comparadas entre os grupos usando o teste de qui-quadrado ou análise de variância (ANOVA, na sigla em inglês). Os impactos dos pró-hormônios adrenais e suas razões com a testosterona total na predição de comorbidades em mulheres com SOP foram determinados por regressão logística univariada e multivariada.

Resultados Hiperandrogenismo adrenal foi encontrado em 32% das mulheres com SOP. Nos controles, a dehidroepiandrosterona e seu sulfato (DHEAS) não mostraram significância na predição das alterações clínicas, antropométricas e metabólicas. Em mulheres com SOP, principalmente no grupo de mulheres com hiperandrogenemia, a dehidroepiandrosterona (DHEA) mostrou ser um preditor significante da maioria das anormalidades nos índices antropométrico-metabólicos (odds ratio [OR] = 0,36–0,97; p < 0,05) e aumento nos níveis de triglicerídeos (TG) (OR = 0,76; p = 0,006). A DHEAS apresentou ter pouco valor na predição dos distúrbios associados à SOP; nas mulheres com androgênios elevados, restringiu-se à predição da elevação do índice de conicidade (IC) (OR = 0,31; p = 0,028).

Conclusão A DHEA mostrou ser um melhor preditor na identificação das alterações dos parâmetros antropométricos e bioquímicos em mulheres com SOP do que o seu sulfato. Assim, em relação aos pró-hormônios adrenais, a dosagem de DHEA, em vez de DHEAS, parece ser mais útil no manejo da SOP. O papel dos pró-hormônios adrenais na predição de anormalidades antropométricas e metabólicas da SOP é limitado.

Keywords

polycystic ovary syndrome - hyperandrogenism - obesity - hyperinsulinemia - metabolism

Palavras-chave

síndrome dos ovários policísticos - hiperandrogenismo - obesidade - hiperinsulinemia - metabolismo

Contributions

Medeiros S. F.: design, data description, statistical analysis, and writing of the manuscript; Medeiros M. A. S.: data search, revision of the manuscript; Barbosa B. B.: data search, data analysis, revision of the manuscript; Medeiros A. K. L. W. Y.: data search, revision of the manuscript. Yamamoto M. M. W.: data search, revision of the manuscript. All authors approved the final version of the manuscript.


Supplementary Material



Publication History

Received: 22 January 2021

Accepted: 15 September 2021

Article published online:
25 February 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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