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Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS.
J Ovarian Res. 2021 Feb 14; 14(1):32.JO

Abstract

BACKGROUND

The aims of this study were to compare the efficacy of different androgens measured by liquid chromatography-mass spectrometry (LC-MS/MS) in representing hyperandrogenemia and to evaluate adrenal-origin androgens with a dexamethasone suppression test in patients with polycystic ovary syndrome (PCOS).

METHODS

One hundred and two patients with PCOS and 41 healthy volunteers were recruited and total serum testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were measured by LC-MS/MS. ROC analysis was performed to compare the efficacy of different androgens in representing hyperandrogenemia. Dexamethasone suppression test was performed in 51 patients with PCOS and above indicators were measured after dexamethasone administration. The prediction efficacy of DHEA and DHEA-S at baseline in the dexamethasone suppression test was evaluated with ROC analysis.

RESULTS

The AUCs of TT, AD, free androgen index (FAI) and DHEA-S in ROC analysis for representing hyperandrogenemia were 0.816, 0.842, 0.937 and 0.678, respectively. The optimal cutoff value of TT was 0.337 ng/ml, with a sensitivity of 72.0% and specificity of 82.93%. The optimal cutoff value for AD was 1.309 ng/ml, with a sensitivity of 81.0% and specificity of 73.17%. The optimal cutoff value of the FAI was 2.50, with a sensitivity of 87.0% and specificity of 92.68%. Alternatively, AD or FAI more than the optimal cutoff values as evidence of hyperandrogenemia had the highest sensitivity of 91.18%. The levels of cortisol, DHEA and DHEA-S were all suppressed to narrow ranges after dexamethasone administration. Nine and 8 of 51 patients with PCOS had significant decreases in TT and AD, respectively. DHEA can be used as a indicator for predicting significant decrease of TT in dexamethasone suppression test with cutoff value of 13.28 ng/ml. A total of 27.5% (14/51) of patients had DHEA-S excess, but only 1 of 9 patients who had a significant decrease in TT had elevated level of DHEA-S at baseline.

CONCLUSIONS

AD measured by LC-MS/MS can represent hyperandrogenemia in PCOS patients and, combined with TT or FAI, can improve the screening efficiency of hyperandrogenemia. Seventeen percent of PCOS patients had adrenal-origin androgen dominance, with TT significantly decreasing after 2 days of dexamethasone administration. Adrenal-origin androgen dominance was not parallel with DHEA-S excess in patients with PCOS.

Authors+Show Affiliations

Department of Clinical Nutrition, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China. Laboratory of Molecular Cardiology and Laboratory of Molecular Imaging, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China.Department of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou, 515041, Guangdong, China. yinguoshu@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33583431

Citation

Chen, Fu, et al. "Comparison of the Efficacy of Different Androgens Measured By LC-MS/MS in Representing Hyperandrogenemia and an Evaluation of Adrenal-origin Androgens With a Dexamethasone Suppression Test in Patients With PCOS." Journal of Ovarian Research, vol. 14, no. 1, 2021, p. 32.
Chen F, Chen M, Zhang W, et al. Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS. J Ovarian Res. 2021;14(1):32.
Chen, F., Chen, M., Zhang, W., Yin, H., Chen, G., Huang, Q., Yang, X., Chen, L., Lin, C., & Yin, G. (2021). Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS. Journal of Ovarian Research, 14(1), 32. https://doi.org/10.1186/s13048-021-00781-5
Chen F, et al. Comparison of the Efficacy of Different Androgens Measured By LC-MS/MS in Representing Hyperandrogenemia and an Evaluation of Adrenal-origin Androgens With a Dexamethasone Suppression Test in Patients With PCOS. J Ovarian Res. 2021 Feb 14;14(1):32. PubMed PMID: 33583431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS. AU - Chen,Fu, AU - Chen,Minjie, AU - Zhang,Weichun, AU - Yin,Huihuang, AU - Chen,Guishan, AU - Huang,Qingxia, AU - Yang,Xiaoping, AU - Chen,Lan, AU - Lin,Chujia, AU - Yin,Guoshu, Y1 - 2021/02/14/ PY - 2020/06/30/received PY - 2021/02/02/accepted PY - 2021/2/15/entrez PY - 2021/2/16/pubmed PY - 2021/9/3/medline KW - Adrenal KW - Androgen KW - Dexamethasone suppression test KW - Liquid chromatography-mass spectrometry (LC-MS/MS) KW - Polycystic ovary syndrome (PCOS) SP - 32 EP - 32 JF - Journal of ovarian research JO - J Ovarian Res VL - 14 IS - 1 N2 - BACKGROUND: The aims of this study were to compare the efficacy of different androgens measured by liquid chromatography-mass spectrometry (LC-MS/MS) in representing hyperandrogenemia and to evaluate adrenal-origin androgens with a dexamethasone suppression test in patients with polycystic ovary syndrome (PCOS). METHODS: One hundred and two patients with PCOS and 41 healthy volunteers were recruited and total serum testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were measured by LC-MS/MS. ROC analysis was performed to compare the efficacy of different androgens in representing hyperandrogenemia. Dexamethasone suppression test was performed in 51 patients with PCOS and above indicators were measured after dexamethasone administration. The prediction efficacy of DHEA and DHEA-S at baseline in the dexamethasone suppression test was evaluated with ROC analysis. RESULTS: The AUCs of TT, AD, free androgen index (FAI) and DHEA-S in ROC analysis for representing hyperandrogenemia were 0.816, 0.842, 0.937 and 0.678, respectively. The optimal cutoff value of TT was 0.337 ng/ml, with a sensitivity of 72.0% and specificity of 82.93%. The optimal cutoff value for AD was 1.309 ng/ml, with a sensitivity of 81.0% and specificity of 73.17%. The optimal cutoff value of the FAI was 2.50, with a sensitivity of 87.0% and specificity of 92.68%. Alternatively, AD or FAI more than the optimal cutoff values as evidence of hyperandrogenemia had the highest sensitivity of 91.18%. The levels of cortisol, DHEA and DHEA-S were all suppressed to narrow ranges after dexamethasone administration. Nine and 8 of 51 patients with PCOS had significant decreases in TT and AD, respectively. DHEA can be used as a indicator for predicting significant decrease of TT in dexamethasone suppression test with cutoff value of 13.28 ng/ml. A total of 27.5% (14/51) of patients had DHEA-S excess, but only 1 of 9 patients who had a significant decrease in TT had elevated level of DHEA-S at baseline. CONCLUSIONS: AD measured by LC-MS/MS can represent hyperandrogenemia in PCOS patients and, combined with TT or FAI, can improve the screening efficiency of hyperandrogenemia. Seventeen percent of PCOS patients had adrenal-origin androgen dominance, with TT significantly decreasing after 2 days of dexamethasone administration. Adrenal-origin androgen dominance was not parallel with DHEA-S excess in patients with PCOS. SN - 1757-2215 UR - https://www.unboundmedicine.com/medline/citation/33583431/Comparison_of_the_efficacy_of_different_androgens_measured_by_LC_MS/MS_in_representing_hyperandrogenemia_and_an_evaluation_of_adrenal_origin_androgens_with_a_dexamethasone_suppression_test_in_patients_with_PCOS_ DB - PRIME DP - Unbound Medicine ER -