1
|
Suturina L, Lizneva D, Atalyan A, Lazareva L, Belskikh A, Bairova T, Sholokhov L, Rashidova M, Danusevich I, Nadeliaeva I, Belenkaya L, Darzhaev Z, Sharifulin E, Belkova N, Igumnov I, Trofimova T, Khomyakova A, Ievleva K, Babaeva N, Egorova I, Salimova M, Yildiz BO, Legro RS, Stanczyk FZ, Azziz R. Establishing Normative Values to Determine the Prevalence of Biochemical Hyperandrogenism in Premenopausal Women of Different Ethnicities from Eastern Siberia. Diagnostics (Basel) 2022; 13:diagnostics13010033. [PMID: 36611327 PMCID: PMC9818891 DOI: 10.3390/diagnostics13010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Androgen assessment is a key element for diagnosing polycystic ovary syndrome (PCOS), and defining a "normal" level of circulating androgens is critical for epidemiological studies. We determined the upper normal limits (UNLs) for androgens in a population-based group of premenopausal "healthy control" women, overall and by ethnicity (Caucasian and Asian), in the cross-sectional Eastern Siberia PCOS Epidemiology and Phenotype (ESPEP) Study (ClinicalTrials.gov ID: NCT05194384) conducted in 2016-2019. Overall, we identified a "healthy control" group consisting of 143 healthy premenopausal women without menstrual dysfunction, hirsutism, polycystic ovaries, or medical disorders. We analyzed serum total testosterone (TT) by using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and DHEAS, sex-hormone-binding globulin (SHBG), TSH, prolactin, and 17-hydroxyprogesterone (17OHP) were assessed with an enzyme-linked immunosorbent assay (ELISA). The UNLs for the entire population for the TT, free androgen index (FAI), and DHEAS were determined as the 98th percentiles in healthy controls as follows: 67.3 (95% confidence interval (CI): 48.1, 76.5) ng/dl, 5.4 (3.5, 14.0), and 355 (289, 371) μg/dl, respectively. The study results demonstrated that the UNLs for TT and FAI varied by ethnicity, whereas the DHEAS UNLs were comparable in the ethnicities studied.
Collapse
Affiliation(s)
- Larisa Suturina
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
- Correspondence: ; Tel.: +7-902-5774-906
| | - Daria Lizneva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
- Center of Excellence for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Alina Atalyan
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Ludmila Lazareva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Aleksey Belskikh
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Tatyana Bairova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Leonid Sholokhov
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Maria Rashidova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Irina Danusevich
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Iana Nadeliaeva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Lilia Belenkaya
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Zorikto Darzhaev
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Eldar Sharifulin
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Natalia Belkova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Ilia Igumnov
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Tatyana Trofimova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Anastasiya Khomyakova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Kseniia Ievleva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Natalia Babaeva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Irina Egorova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Madinabonu Salimova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Bulent O. Yildiz
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe, 06100 Ankara, Turkey
| | - Richard S. Legro
- Hershey Medical Center, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA
| | - Frank Z. Stanczyk
- Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Ricardo Azziz
- School of Medicine and Public Health, University of Alabama at Birmingham, 1700 6th Ave, South Birmingham, AL 35249, USA
| |
Collapse
|
2
|
Pérez-Acosta A, Duque X, Trejo-Valdivia B, Flores-Huerta S, Flores-Hernández S, Martínez-Andrade G, González-Unzaga M, Turnbull B, Escalante-Izeta E, Klünder-Klünder M, Carranco-Hernández T, Mendoza E, Sotelo-Ham EI, Pineda A, Medina-Escobedo C, Martinez H. Cut-off points for serum ferritin to identify low iron stores during the first year of life in a cohort of Mexican infants. MATERNAL AND CHILD NUTRITION 2021; 17:e13205. [PMID: 34036744 PMCID: PMC8476433 DOI: 10.1111/mcn.13205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/08/2021] [Accepted: 04/28/2021] [Indexed: 12/31/2022]
Abstract
The aim of this study was to identify serum ferritin (SF) cut‐off points (COPs) in a cohort of healthy full‐term normal birth weight infants who had repeated measurements of SF and haemoglobin every 3 months during the first year of life. The study included 746 full‐term infants with birth weight ≥2,500 g, having uncomplicated gestations and births. Participants received prophylactic iron supplementation (1 mg/day of iron element) from the first to the 12th month of life and did not develop anaemia during the first year of life. Two statistical methods were considered to identify COPs for low iron stores at 3, 6, 9 and 12 months of age: deviation from mean and cluster analysis. According to the K‐means cluster analysis results by age and sex, COPs at 3 and 6 months for girls were 39 and 21 μg/L and for boys 23 and 11 μg/L, respectively. A single COP of 10 μg/L was identified, for girls and boys, at both 9 and 12 months. Given the physiological changes in SF concentration during the first year of life, our study identified dynamic COPs, which differed by sex in the first semester. Adequate SF COPs are necessary to identify low iron stores at an early stage of iron deficiency, which represents one of the most widespread public health problems around the world, particularly in low‐ and middle‐income countries.
Collapse
Affiliation(s)
- Azucena Pérez-Acosta
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Ximena Duque
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Belem Trejo-Valdivia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Samuel Flores-Huerta
- Unidad de Investigación en Salud Comunitaria, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | - Sergio Flores-Hernández
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Gloria Martínez-Andrade
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Marco González-Unzaga
- Unidad de Investigación en Epidemiología Nutricional, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Bernardo Turnbull
- Académico de tiempo, Universidad Iberoamericana, Ciudad de México, México
| | - Ericka Escalante-Izeta
- Departamento de Ciencias de la Salud, Universidad Iberoamericana, San Andrés Cholula, Puebla, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | - Tania Carranco-Hernández
- Dirección de Prestaciones Económicas y Sociales, Coordinación del Servicio de Guardería para el Desarrollo Integral Infantil, División de Desarrollo Integral Infantil, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Eugenia Mendoza
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Elma Ivonne Sotelo-Ham
- Coordinación Delegacional de Investigación de Zacatecas, Instituto Mexicano del Seguro Social, Zacatecas, México
| | - Alicia Pineda
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, México
| | - Carolina Medina-Escobedo
- Dirección de Educación e Investigación en Salud. Unidad Médica de Alta Especialidad, Hospital de Especialidades Centro Médico Nacional "Ignacio García Téllez" en Mérida, Instituto Mexicano del Seguro Social, Mérida, México
| | - Homero Martinez
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México.,Global Technical Services, Nutrition International, Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Ding M, Liu Y, Yang Y, Ye Y, Li L, Huang J, Chen X, Yang D, Zhao X. The Cutoff Value of Low Sex Hormone-Binding Globulin and Its Predictive Role in Impaired Glucose Metabolism Among Chinese Women with Polycystic Ovarian Syndrome. Metab Syndr Relat Disord 2021; 19:378-385. [PMID: 33945333 DOI: 10.1089/met.2020.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Low levels of sex hormone-binding globulin (SHBG) is a potential predictor of type 2 diabetes mellitus (T2DM), and when combined with insulin resistance (IR), lead to impaired glucose metabolism. Few studies involve women with polycystic ovarian syndrome (PCOS). Studies on cutoff values of SHBG among Asian women were scanty. Methods: The cutoff level of SHBG was computed using the 25th percentile method. Parameters were compared between the lower and higher SHBG subgroup. Area under the curve (AUC) for sensitivity and specificity of SHBG in predicting IR and impaired glucose metabolism was calculated. Results: This study included 733 patients with PCOS 20-45 years of age and 469 age-matched controls. The 25th percentile of SHBG in the control group was 51.90 nM. There were negative correlations between SHBG and age (r = -0.085, P < 0.05), body mass index (BMI) (r = -0.461, P < 0.01), waist-to-hip ratio (WHR) (r = -0.349, P < 0.01), fasting plasma glucose (r = -0.242, P < 0.01), Glucose-1h (r = -0.303, P < 0.01), Glucose-2h (r = -0.336, P < 0.01), fasting insulin (r = -0.324, P < 0.01), Insulin-1h (r = -0.238, P < 0.01), Insulin-2h (r = -0.307, P < 0.01), and homeostasis model 2 assessment of insulin resistance (HOMA2-IR) (r = -0.329, P < 0.01). Age, BMI, WHR, glucose and insulin levels (both pre- and postload), HOMA2-IR, free testosterone, and dehydroepiandrosterone sulfate were all higher in the lower than the higher SHBG subgroup. The AUC of SHBG for predicting IR was 0.706 [95% confidence interval (CI) 0.665-0.745, P < 0.001], impaired fasting glucose was 0.674 (95% CI 0.513-0.838, P < 0.001), impaired glucose tolerance was 0.637 (95% CI 0.586-0.690, P < 0.001), and T2DM was 0.674 (95% CI 0.556-0.780, P < 0.001). Conclusions: A 51.90 nM should be identified as the cutoff value of SHBG. Women with PCOS with lower SHBG values have a higher risk of developing impaired glucose metabolism. Low SHBG should be a predictive biomarker of impaired glucose metabolism in women with PCOS in southern China.
Collapse
Affiliation(s)
- Miao Ding
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yong Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Hematologic Laboratory of Pediatrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yabo Yang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang Ye
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lin Li
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia Huang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Chen
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dongzi Yang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomiao Zhao
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
4
|
Lin H, Liu M, Zhong D, Ng EHY, Liu J, Li J, Shi Y, Zhang C, Wen X, Mai Z, Ou M, Ma H. The Prevalence and Factors Associated With Anxiety-Like and Depression-Like Behaviors in Women With Polycystic Ovary Syndrome. Front Psychiatry 2021; 12:709674. [PMID: 34744814 PMCID: PMC8563587 DOI: 10.3389/fpsyt.2021.709674] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/16/2021] [Indexed: 02/04/2023] Open
Abstract
Increasing evidence shows that polycystic ovary syndrome (PCOS) patients are particularly vulnerable to anxiety/depression-like behaviors. This study sought to determine the prevalence of anxiety/depression-like behaviors among women with PCOS and to identify factors associated with these behaviors. This study was a secondary analysis of three studies performed on Chinese women who were aged 18 to 40 and diagnosed with PCOS according to the modified Rotterdam criteria. We obtained 802 useable responses for the self-rating anxiety scale and 798 responses for the self-rating depression scale. The prevalence of anxiety-like and depression-like behaviors among women with PCOS was 26.1% (209/802) and 52.0% (415/798), respectively. Anxiety-like behaviors were associated with age, body image-related factors (including body mass index and waist-to-hip ratio), and hyperandrogenism-related factors (including free androgen index and hirsutism). Depression-like behaviors were associated with age, body image-related factors, hyperandrogenism-related factors, and metabolic factors (including fasting insulin, fasting plasma glucose, and homeostatic model assessment of insulin resistance). Body image-related factors and hyperandrogenism-related factors were related to both anxiety-like behaviors and depression-like behaviors in both infertile and fertile PCOS patients.
Collapse
Affiliation(s)
- Han Lin
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingxing Liu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dongmei Zhong
- Department of Gynecology of Traditional Chinese Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynecology, the University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, Hong Kong, SAR China
| | - Jianping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Li
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Shi
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunren Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohui Wen
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhefen Mai
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Miaoxian Ou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxia Ma
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
5
|
Yang Y, Ouyang N, Ye Y, Hu Q, Du T, Di N, Xu W, Azziz R, Yang D, Zhao X. The predictive value of total testosterone alone for clinical hyperandrogenism in polycystic ovary syndrome. Reprod Biomed Online 2020; 41:734-742. [PMID: 32912651 DOI: 10.1016/j.rbmo.2020.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION Is the sole measurement of total testosterone sufficient to assess the presence of hyperandrogenism in women with polycystic ovary syndrome (PCOS)? DESIGN Serum samples from 294 patients with PCOS who met the Rotterdam criteria were used for the analysis of total testosterone by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and chemiluminescent immunoassay (CLIA). The free androgen index (FAI) was calculated as total testosterone (TT)/sex hormone-binding globulin (SHBG) × 100%, and the presence/degree of hirsutism were assessed using the modified and simplified Ferriman-Gallwey (mFG and sFG, respectively) scoring systems. RESULTS The hirsute subjects presented higher LC-MS/MS-based total testosterone and FAI values than the non-hirsute subjects (all P < 0.001), including those defined based on mFG ≥5 or sFG ≥3. Total testosterone and FAI were both positively correlated with the mFG (rank correlation coefficient [RCC] 0.598 and 0.443, P < 0.001) or sFG (RCC 0.747 and 0.568, P < 0.001) score, and a receiver operating characteristic curve analysis indicated that both parameters could significantly predict the presence of hirsutism determined by the mFG (area under the curve [AUC] 0.797 and 0.725, P < 0.001) or sFG (AUC 0.894 and 0.817, P < 0.001) score. However, similar results were not obtained with the CLIA platform. CONCLUSIONS In this East Asian population, total testosterone was found to be a strong predictor of the presence and degree of hyperandrogenism (i.e. assessed by the presence and degree of hirsutism), but this finding was obtained only if the total testosterone level was measured by LC-MS/MS and not by CLIA. These findings might have important implications for global epidemiologic, phenotypic and clinical studies of PCOS.
Collapse
Affiliation(s)
- Yabo Yang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Nengyong Ouyang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Yang Ye
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Qin Hu
- Kobilka Institute of Innovative Drug Discovery, Chinese University of Hong Kong (Shenzhen), Shenzhen 518172, China
| | - Tao Du
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Na Di
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Wenming Xu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu 610041, China
| | - Ricardo Azziz
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, SUNY, Rensselaer NY 12144, USA
| | - Dongzi Yang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China.
| | - Xiaomiao Zhao
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China.
| |
Collapse
|
6
|
Dulohery K, Trottmann M, Bour S, Liedl B, Alba-Alejandre I, Reese S, Hughes B, Stief CG, Kölle S. How do elevated levels of testosterone affect the function of the human fallopian tube and fertility?-New insights. Mol Reprod Dev 2019; 87:30-44. [PMID: 31705839 DOI: 10.1002/mrd.23291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 10/14/2019] [Indexed: 12/25/2022]
Abstract
Excess testosterone levels affect up to 20% of the female population worldwide and are a key component in the pathogenesis of polycystic ovary syndrome. However, little is known about how excess testosterone affects the function of the human fallopian tube-the site of gamete transport, fertilization, and early embryogenesis. Therefore, this study aimed to characterize alterations caused by long-term exposure to male testosterone levels. For this purpose, the Fallopian tubes of nine female-to-male transsexuals, who had been undergoing testosterone treatment for 1-3 years, were compared with the tubes of 19 cycling patients. In the ampulla, testosterone treatment resulted in extensive luminal accumulations of secretions and cell debris which caused ciliary clumping and luminal blockage. Additionally, the percentage of ciliated cells in the ampulla was significantly increased. Transsexual patients, who had had sexual intercourse before surgery, showed spermatozoa trapped in mucus. Finally, in the isthmus complete luminal collapse occurred. Our results imply that fertility in women with elevated levels of testosterone is altered by tubal luminal obstruction resulting in impaired gamete transport and survival.
Collapse
Affiliation(s)
- Kate Dulohery
- School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | | | - Susanne Bour
- Department of Urology, Klinikum Grosshadern, LMU Munich, Germany
| | - Bernhard Liedl
- Department of Urogenital Surgery, Clinic for Surgery Munich-Bogenhausen, Munich, Germany
| | | | - Sven Reese
- Department of Veterinary Sciences, Institute of Veterinary Anatomy, Histology and Embryology, LMU Munich, Munich, Germany
| | - Barbara Hughes
- School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | | | - Sabine Kölle
- School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
| |
Collapse
|
7
|
Li J, Wu Q, Wang CC, Wang R, Ng EHY, Liu JP, Mol BWJ, Wu XK, Li WT. Endocrine characteristics, body mass index and metabolic syndrome in women with polycystic ovary syndrome. Reprod Biomed Online 2019; 39:868-876. [PMID: 31444050 DOI: 10.1016/j.rbmo.2019.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/15/2019] [Accepted: 06/28/2019] [Indexed: 12/17/2022]
Abstract
RESEARCH QUESTION The study aimed to evaluate the associations of endocrine and ultrasound characteristics with metabolic syndrome in women with polycystic ovary syndrome (PCOS), and whether these associations were modified by body mass index (BMI). DESIGN The study was a secondary analysis of baseline data from a randomized controlled trial of induction of ovulation in women with PCOS. RESULTS Among 947 Chinese women with PCOS, 153 (16.2%) were diagnosed with metabolic syndrome. The prevalence of metabolic syndrome in women with normal (<24 kg/m2) and high (≥24 kg/m2) BMI was 3.6% and 30.5%, respectively. In all women, a high free androgen index (FAI ≥5%) was positively associated with metabolic syndrome (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.11-3.82). High FAI was positively associated with metabolic syndrome among women with high BMI (adjusted OR 3.37, 95% CI 1.78-6.37), but the association was not significant in women with normal BMI (adjusted OR 1.27, 95% CI 0.34-4.70). The presence of polycystic ovary morphology was negatively associated with metabolic syndrome (adjusted OR 0.52, 95% CI 0.26-1.03) in all women (normal BMI adjusted OR 0.42, 95% CI 0.11-1.67; high BMI adjusted OR 0.54, 95% CI 0.23-1.28). LH, sex hormone-binding globulin (SHBG) and anti-Müllerian hormone (AMH) were negatively associated with metabolic syndrome. The associations of FAI, SHBG and AMH in relation to metabolic syndrome were significantly modified by BMI. CONCLUSION(S) The associations of endocrine characteristic with metabolic syndrome were modified by BMI in women with PCOS. Women with PCOS and normal BMI did not have an increased risk of metabolic syndrome.
Collapse
Affiliation(s)
- Jian Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qi Wu
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong; Reproduction and Development Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Rui Wang
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, North Adelaide, Australia
| | - Ernest H Y Ng
- Department of Obstetrics and Gynecology, The University of Hong Kong, Hong Kong
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Clayton Victoria, Australia
| | - Xiao-Ke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wen-Tao Li
- Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, Clayton Victoria, Australia
| | | |
Collapse
|
8
|
Di N, Zhou X, Chen Y, Zhao X, Li L, Jiang L, Luo B, Chen X, Yang D. Could semiquantitative analysis of real-time ultrasound elastography distinguish more liver parenchyma alterations of nonalcoholic fatty liver disease in patients with polycystic ovary syndrome? ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:128-136. [PMID: 30916169 PMCID: PMC10522130 DOI: 10.20945/2359-3997000000119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/12/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease is the commonest diffuse liver disease, of which women with polycystic ovary syndrome are at an increased risk. The aim of the present study was to assess the diagnostic value of the semiquantitative strain parameters of real-time ultrasound elastography for nonalcoholic fatty liver disease in patients with polycystic ovary syndrome. SUBJECTS AND METHODS Thirty-five polycystic ovary syndrome patients with nonalcoholic fatty liver disease, 70 polycystic ovary syndrome patients without nonalcoholic fatty liver disease, and 70 healthy female controls of reproductive age were included. All participants underwent ultrasonic examination and semiquantitative analysis of real-time ultrasound elastography of the liver. RESULTS Main semi quantitative strain parameters, such as average strain value, differed significantly among groups polycystic ovary syndrome with nonalcoholic fatty liver disease, polycystic ovary syndrome without nonalcoholic fatty liver disease, and control (87.02 ± 10.16 vs. 96.31 ± 11.44 vs. 104.49 ± 7.28, p < 0.001). Clinical and laboratory parameters differed significantly between the two subgroups with low or high average strain value. For diagnostic value of average strain value for elevated aminotransferase, the area under the curve was 0.808 (range 0.721-0.895). In multiple linear regression analysis, polycystic ovary syndrome, waist circumference, and metabolic syndrome were stand-alone independent factors associated with average strain value among subjects without nonalcoholic fatty liver disease. CONCLUSION Semiquantitative real-time ultrasound elastography analysis could distinguish liver parenchyma alterations in patients with polycystic ovary syndrome more sensitively. The diagnostic value of the proposed method for nonalcoholic fatty liver disease need further research.
Collapse
Affiliation(s)
- Na Di
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of UltrasoundGuangzhouChinaDepartment of Ultrasound, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xinchuan Zhou
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of UltrasoundGuangzhouChinaDepartment of Ultrasound, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yaxiao Chen
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomiao Zhao
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lin Li
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Linlin Jiang
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Baoming Luo
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of UltrasoundGuangzhouChinaDepartment of Ultrasound, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Chen
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dongzi Yang
- Sun Yat-sen UniversitySun Yat-sen UniversitySun Yat-sen Memorial HospitalDepartment of Obstetrics and GynecologyGuangzhouChinaDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
9
|
Yang Y, Ding M, Di N, Azziz R, Yang D, Zhao X. Close correlation between hyperandrogenism and insulin resistance in women with polycystic ovary syndrome-Based on liquid chromatography with tandem mass spectrometry measurements. J Clin Lab Anal 2018; 33:e22699. [PMID: 30350882 DOI: 10.1002/jcla.22699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To investigate the correlation between hyperandrogenism (HA) and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) by measuring serum total testosterone (TT) using a liquid chromatography and tandem mass spectrometry assay (LC-MS/MS). METHODS This cohort study included 332 patients with PCOS, 63 patients with IR and 276 with controls. TT levels were measured by LC-MS/MS and chemiluminescent immunoassay (CLIA); glucose and insulin levels were determined by an oral glucose tolerance test (OGTT). RESULTS Compared with CLIA, LC-MS/MS differentiated more cases with high TT levels among the non-PCOS subjects with IR In patients with PCOS, LC-MS/MS-based TT levels or a combination with the mFG score detected a significantly higher incidence of HA in subjects with IR identified by hyperinsulinemia (HIN), HOMA-IR or impaired fasting glucose (IFG) than in those without IR Conversely, the IR rates demonstrated by HIN, HOMA-IR, or IFG were remarkably higher in the LC-MS/MS-defined high TT subgroup than in the normal TT subgroup. However, the CLIA platform could not discern a difference in HA incidence between IR and non-IR subgroups or in IR rate between high and normal TT populations. ROC curves also proved that HIN, HOMA-IR, and IFG were positive contributors to HA as measured by LC-MS/MS CONCLUSIONS: The correlation between HA and IR has always been underestimated, partly owing to the less accurate methods previously used to measure TT. HIN, HOMA-IR, and IFG are likely to contribute to the development of HA from a clinical perspective.
Collapse
Affiliation(s)
- Yabo Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Miao Ding
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Na Di
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ricardo Azziz
- Academic Health and Hospital Affairs, State University of New York (SUNY) System Administration, New York, New York
| | - Dongzi Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomiao Zhao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
10
|
Zhou Z, Li R, Qiao J. Androgen profile in Chinese women with polycystic ovary syndrome in their reproductive years. Reprod Biomed Online 2017; 35:331-339. [DOI: 10.1016/j.rbmo.2017.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 05/09/2017] [Accepted: 05/25/2017] [Indexed: 11/28/2022]
|
11
|
Guo J, Zhang Q, Li Y, Wang W, Yang D. Low level of basal testosterone: a significant risk factor for poor oocyte yield after ovulation induction. Reprod Fertil Dev 2017; 28:286-92. [PMID: 25023952 DOI: 10.1071/rd14061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 05/23/2014] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to further investigate the association of low androgen levels and poor ovarian response or negative pregnancy outcome in in vitro fertilisation treatment using a retrospective cohort study. Chinese women (n=1950) of relatively young age, with normal range of basal FSH and antral follicle count undergoing an in vitro fertilisation cycle were selected and testosterone and dehydroepiandrosterone sulfate levels were measured on Day 3 of the menstrual cycle before subsequent in vitro fertilisation treatment. The main outcome measures of the study were ovarian stimulation parameters and clinical pregnancy. Basal testosterone levels of poor responders and non-pregnant women were significantly lower than normal responders and pregnant women, respectively. Patients with low basal testosterone levels had significantly lower number of mature oocytes, cleavage-stage embryos, frozen embryos, lower fertilisation and pregnancy rates and required higher doses of gonadotrophins. Androgen levels had no correlation with early spontaneous abortion rates. Multivariable logistic analysis revealed that low basal testosterone (<0.88nmolL(-1)) was an independent risk factor for poor oocyte yield (odds ratio: 1.61; 95% confidence interval: 1.01-2.57; P=0.045). In conclusion, a low level of basal testosterone was a significant risk factor for poor oocyte yield after ovarian stimulation and might negatively influence pregnancy chances with in vitro fertilisation. Basal dehydroepiandrosterone sulfate levels were not predictive for poor ovarian response or negative pregnancy outcome in this population.
Collapse
Affiliation(s)
- Jing Guo
- Department of Obstetrics and Gynaecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou 510120, Guangdong, China
| | - Qingxue Zhang
- Department of Obstetrics and Gynaecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou 510120, Guangdong, China
| | - Yu Li
- Department of Obstetrics and Gynaecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou 510120, Guangdong, China
| | - Wenjun Wang
- Department of Obstetrics and Gynaecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou 510120, Guangdong, China
| | - Dongzi Yang
- Department of Obstetrics and Gynaecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou 510120, Guangdong, China
| |
Collapse
|
12
|
Predictive value of androgens and multivariate model for poor ovarian response. Reprod Biomed Online 2014; 28:723-32. [DOI: 10.1016/j.rbmo.2014.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 02/11/2014] [Accepted: 02/11/2014] [Indexed: 11/19/2022]
|
13
|
Hashemi S, Ramezani Tehrani F, Noroozzadeh M, Azizi F. Normal cut-off values for hyperandrogenaemia in Iranian women of reproductive age. Eur J Obstet Gynecol Reprod Biol 2013; 172:51-5. [PMID: 24220143 DOI: 10.1016/j.ejogrb.2013.09.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/07/2013] [Accepted: 09/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The normal cut-off values for hyperandrogenaemia differ between populations. Although there are various ways to determine the normal range of hormones in a population, use of a gold standard and the 95th percentile approach are not appropriate to diagnose hyperandrogenism. This study aimed to determine normative cut-off androgen levels for Iranian women of reproductive age using k-means cluster analysis. STUDY DESIGN The subjects were 1126 women, aged 18-45 years, initially selected at random from women of reproductive age from different geographic regions of Iran. Serum levels of hormones were measured, and complete data were available for 923 women following the implementation of exclusion criteria. The reference group comprised 423 eumenorrhoeic non-hirsute women selected from the total population. Normative cut-off levels were computed using k-means cluster analysis (k=3). Analyses were also conducted based on age and body mass index (BMI) groups for the 923 subjects. RESULTS Cluster cut-off values for the total study population were similar to the 95th percentile values, whereas the percentiles for the free androgen index, total testosterone, dehydroepiandrostenedione sulphate and androstenedione were 79.3%, 74.1%, 96.7% and 71%, respectively, in the reference group. CONCLUSIONS Determination of cut-off values for hyperandrogenism based on age and BMI categories provides the most objective way of determining normal upper limits of androgen levels among Iranian women of reproductive age.
Collapse
Affiliation(s)
- Somayeh Hashemi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahsa Noroozzadeh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Zhou Z, Ni R, Hong Y, Li Y, Wang Y, Zhao X, Yang D. Defining hyperandrogenaemia according to the free androgen index in Chinese women: a cross-sectional study. Clin Endocrinol (Oxf) 2012; 77:446-52. [PMID: 22443308 DOI: 10.1111/j.1365-2265.2012.04395.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE(S) To determine the normative cut-off value for the free androgen index (FAI) among reproductive-age women in China. DESIGN Cross-sectional, population-based study. SETTING A multistage systematic cluster random sampling among 16 communities from two rural and two city regions. PATIENT(S) A total of 1526 women were randomly selected from a representative sample of 3009 women aged 20-45 years from the general population of southern China. Among these women, 444 subjects without known factors affecting androgen levels were selected as the reference group. INTERVENTION(S) Subjects underwent physical examination, blood tests of hormone and metabolic profiles, and ultrasound evaluations. MEASUREMENT OF THE MAIN OUTCOMES: The FAI was calculated according to the following equation: FAI = 100 × total testosterone (nmol/l)/sex hormone-binding globulin (nmol/l). The normative cut-off value of the FAI was computed based on the 5th-95th percentiles and K-means cluster analysis (K = 2). RESULTS A reference range of 0·7-6·4 of the FAI was indicated by the 5th and 95th percentiles. K-means cluster analysis identified 6·1 as the cut-off value for the FAI in the total population, which was close to the upper limit determined by the 95th percentile. Hyperandrogenic women present with elevated risk factors for metabolic disorders. The mean FAI values decreased with age among the total population, as evaluated by either K-means clustering or a percentile analysis. The FAI value was negatively correlated with age (r = -0·185, P < 0·0001) and positively correlated with body mass index after adjustment for age (r = 0·250, P < 0·0001). CONCLUSION A reference range of 0·7-6·4 FAI was indicated by the 5th and 95th percentiles among the reference group, which excluded the subjects with factors known to affect androgen levels; 6·1 was identified by the K-means cluster analysis as the cut-off value of the FAI for the general population. Hyperandrogenic women present with higher risks for metabolic disorders.
Collapse
Affiliation(s)
- Zehong Zhou
- Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | | | | | | | | | | | | |
Collapse
|
15
|
Zhao X, Ni R, Li L, Mo Y, Huang J, Huang M, Azziz R, Yang D. Defining hirsutism in Chinese women: a cross-sectional study. Fertil Steril 2011; 96:792-6. [DOI: 10.1016/j.fertnstert.2011.06.040] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 06/09/2011] [Accepted: 06/14/2011] [Indexed: 10/18/2022]
|