Adrenal Function during Childhood and Puberty in Daughters of Women with Polycystic Ovary Syndrome

Maliqueo, Manuel; Sir-Petermann, Teresa; Pérez, Virginia; Echiburú, Bárbara; Guevara, Amanda Ladrón de; Gálvez, Carla; Crisosto, Nicolás; Azziz, Ricardo

doi:10.1210/jc.2009-0427

Cited by 61 publications

(35 citation statements)

References 40 publications

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“…Inherited defects in the enzymes responsible for abnormal steroidogenesis account for only a very small portion of patients with increased DHEA/DHEAS. In contrast, many PCOS patients under ACTH stimulation display a generalized increase in the adrenal steroid production with no evidence of hypothalamic-pituitary axis dysfunction (88). In-vivo studies have reported that insulin amplifies adrenal steroidogenesis in response to ACTH in PCOS (88,89), which is consistent with in vitro data (90,91).…”

Section: Dheas In Hyperandrogenic States Approximately 20-30% Of Hypsupporting

confidence: 76%

“…In contrast, many PCOS patients under ACTH stimulation display a generalized increase in the adrenal steroid production with no evidence of hypothalamic-pituitary axis dysfunction (88). In-vivo studies have reported that insulin amplifies adrenal steroidogenesis in response to ACTH in PCOS (88,89), which is consistent with in vitro data (90,91). In an opposite way, metformin (92) and thiazolidinedione treatment decrease DHEAS levels in correlation with decreased insulin resistance and hyperinsulinemia in PCOS patients (93,94).…”

Section: Dheas In Hyperandrogenic States Approximately 20-30% Of Hypsupporting

confidence: 65%

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MANAGEMENT OF ENDOCRINE DISEASE Hyperandrogenic states in women: pitfalls in laboratory diagnosis

Pugeat

Plotton

Perrière

et al. 2018

European Journal of Endocrinology

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Measuring total testosterone level is the first-line approach in assessing androgen excess in women.The main pitfalls in measuring testosterone relate to its low concentration and to the structural similarity between circulating androgens and testosterone, requiring accurate techniques with high specificity and sensitivity. These goals can be achieved by immunoassay using a specific antitestosterone monoclonal antibody, ideally after an extraction step. Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) will be commonly used for measuring testosterone, providing optimal accuracy with a low limit of detection. Yet, the pitfalls of these two techniques are well identified and must be recognized and systematically addressed. In general, laboratories using direct testosterone immunoassay and mass spectrometry need to operate within a quality framework and be actively engaged in external quality control processes and standardization, so as to ensure appropriate interpretation irrespective of the particular laboratory. Circulating testosterone is strongly bound to sex-hormone binding-globulin (SHBG), and SHBG levels are typically low in overweight hyperandrogenic patients. Thus, low SHBG may decrease circulating testosterone to normal values, which will mask androgen excess status. One way to avoid this pitfall, awaiting direct free-testosterone assays that are yet to be developed, is to measure SHBG and calculate free testosterone. A few other pitfalls will be discussed in this review, including those of adrenal androgen exploration, with the aim of helping clinicians to better handle laboratory investigation of androgen excess disorders in women.

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Section: Dheas In Hyperandrogenic States Approximately 20-30% Of Hypsupporting

confidence: 76%

Section: Dheas In Hyperandrogenic States Approximately 20-30% Of Hypsupporting

confidence: 65%

MANAGEMENT OF ENDOCRINE DISEASE Hyperandrogenic states in women: pitfalls in laboratory diagnosis

Pugeat

Plotton

Perrière

et al. 2018

European Journal of Endocrinology

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“…A recent study suggested that daughters of PCOS women have exaggerated adrenarche [18], further supporting the association between these conditions. However, it is clear that not all children with PP or PA develop ovarian hyperandogenism or PCOS.…”

Section: Discussionmentioning

confidence: 73%

Serum Anti-Müllerian Hormone Concentrations in Prepubertal Girls with and without Premature Adrenarche: The Influence of Body Mass Index

Utriainen¹,

Jääskeläinen²,

Voutilainen³

2010

Horm Res Paediatr

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Background: A connection between premature adrenarche (PA) and polycystic ovary syndrome (PCOS) has been proposed. We investigated whether anti-müllerian hormone (AMH) production is increased in prepubertal girls with PA, as it is in women with PCOS and in their prepubertal daughters. Methods: Fifty-two prepubertal girls with PA and 48 prepubertal age-matched controls were studied. Serum AMH concentrations were determined by a specific ELISA assay and correlated with baseline steroid hormone, GnRH-stimulated LH and FSH, and glucose and insulin concentrations during an oral glucose tolerance test (OGTT). Results: Girls with PA had lower serum AMH concentrations than their controls (2.65 vs. 3.43 ng/ml, p = 0.035). This difference between the study groups vanished when adjusted for BMI SDS score (SDS) or body fat percentage. In the entire cohort, serum AMH concentration was negatively correlated with BMI SDS (r = –0.23, p = 0.019) and androstenedione (r = –0.22, p = 0.03), but not with age, GnRH-stimulated LH or FSH, baseline or OGTT insulin concentrations. Within the control group only, there was an inverse relationship of serum AMH with DHEAS (r = –0.32, p = 0.028) concentrations. Conclusions: Unlike prepubertal daughters of PCOS women, PA girls do not have abnormalities in serum AMH concentrations at prepubertal age.

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“…This could be explained by a higher fetal adiposity in that group or by the maternal metabolic condition. However, in the daughters of women with PCOS, these investigators discovered higher basal and stimulated dehydroepiandrosterone sulfate (DHEAS) during puberty and an exacerbated adrenarche in 30% of them if compared with controls (146). On the other hand, Hickey et al (147) found no association between maternal blood during pregnancy and cord samples with hyperandrogenism and PCOS in the adolescent daughters recruited in a cohort study.…”

Section: Polycystic Ovary Syndromementioning

confidence: 97%

Reproductive medicine and inheritance of infertility by offspring: the role of fetal programming

Díaz-García

Estella

Perales‐Puchalt

et al. 2011

Fertility and Sterility

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Adrenal Function during Childhood and Puberty in Daughters of Women with Polycystic Ovary Syndrome

Cited by 61 publications

References 40 publications

MANAGEMENT OF ENDOCRINE DISEASE Hyperandrogenic states in women: pitfalls in laboratory diagnosis

MANAGEMENT OF ENDOCRINE DISEASE Hyperandrogenic states in women: pitfalls in laboratory diagnosis

Serum Anti-Müllerian Hormone Concentrations in Prepubertal Girls with and without Premature Adrenarche: The Influence of Body Mass Index

Reproductive medicine and inheritance of infertility by offspring: the role of fetal programming

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