Pekka Pinola1, Terhi T Piltonen1, Johanna Puurunen1, Eszter Vanky1, Inger Sundström-Poromaa1, Elisabet Stener-Victorin1, Aimo Ruokonen1, Katri Puukka1, Juha S Tapanainen1, Laure C Morin-Papunen1. 1. Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland.
Abstract
CONTEXT: Women with polycystic ovary syndrome (PCOS) have increased androgen secretion throughout fertile life; however, the data on the effect of menopause on hyperandrogenemia in these women are scarce. Nevertheless, large comprehensive comparative studies on age-related androgen levels in women with PCOS are lacking. OBJECTIVE: The objective of the study was to investigate the effect of age on serum androgen levels in women with PCOS and to determine cutoff values for androgens and SHBG associated with a PCOS diagnosis. DESIGN: This was a case-control study. SETTING: The study was conducted in five university sites in the Nordic countries. PATIENTS: In all, 681 women with PCOS and 230 referent women were grouped according to age into seven age groups (18 to > 50 y). INTERVENTIONS: There were no interventions. MAIN OUTCOME MEASURES: T, SHBG, free androgen index (FAI), calculated free T (cFT), androstenedione (A4), and dehydroepiandrosterone sulfate were measured. RESULTS: Androgen levels in women with PCOS decreased with age toward menopause. The difference between women with PCOS and the referent women narrowed and individual variation increased as they approached menopause. T levels, FAI, and cFT were significantly higher in women with PCOS aged 18-44 years (P < .001, adjusted for body mass index). The best predictive factors for having PCOS were cFT (≥0.40 ng/dL, odds ratio [OR] 7.90), FAI (≥2.0, OR 6.71), and A4 (≥277.94 ng/dL, OR 6.16). CONCLUSIONS: Women with PCOS had elevated serum androgen levels also after menopause. The parameters that best predicted PCOS at all ages were cFT, A4, and FAI.
CONTEXT: Women with polycystic ovary syndrome (PCOS) have increased androgen secretion throughout fertile life; however, the data on the effect of menopause on hyperandrogenemia in these women are scarce. Nevertheless, large comprehensive comparative studies on age-related androgen levels in women with PCOS are lacking. OBJECTIVE: The objective of the study was to investigate the effect of age on serum androgen levels in women with PCOS and to determine cutoff values for androgens and SHBG associated with a PCOS diagnosis. DESIGN: This was a case-control study. SETTING: The study was conducted in five university sites in the Nordic countries. PATIENTS: In all, 681 women with PCOS and 230 referent women were grouped according to age into seven age groups (18 to > 50 y). INTERVENTIONS: There were no interventions. MAIN OUTCOME MEASURES: T, SHBG, free androgen index (FAI), calculated free T (cFT), androstenedione (A4), and dehydroepiandrosterone sulfate were measured. RESULTS: Androgen levels in women with PCOS decreased with age toward menopause. The difference between women with PCOS and the referent women narrowed and individual variation increased as they approached menopause. T levels, FAI, and cFT were significantly higher in women with PCOS aged 18-44 years (P < .001, adjusted for body mass index). The best predictive factors for having PCOS were cFT (≥0.40 ng/dL, odds ratio [OR] 7.90), FAI (≥2.0, OR 6.71), and A4 (≥277.94 ng/dL, OR 6.16). CONCLUSIONS:Women with PCOS had elevated serum androgen levels also after menopause. The parameters that best predicted PCOS at all ages were cFT, A4, and FAI.
Authors: Catherine Kim; Carrie Karvonen-Gutierrez; Shengchun Kong; Valerie Arends; Michael Steffes; Daniel S McConnell; John F Randolph; Siobán D Harlow Journal: Fertil Steril Date: 2016-07-28 Impact factor: 7.329
Authors: Li-Wei Cho; Thozhukat Sathyapalan; Eric S Kilpatrick; Brian G Keevil; Adrian G Miller; Anne M Coady; Lina Ahmed; Stephen L Atkin Journal: BMC Endocr Disord Date: 2017-05-19 Impact factor: 2.763