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
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 o...
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BMC
2021-02-01
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| Series: | Journal of Ovarian Research |
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| Online Access: | https://doi.org/10.1186/s13048-021-00781-5 |
| _version_ | 1797972249389563904 |
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| author | Fu Chen Minjie Chen Weichun Zhang Huihuang Yin Guishan Chen Qingxia Huang Xiaoping Yang Lan Chen Chujia Lin Guoshu Yin |
| author_facet | Fu Chen Minjie Chen Weichun Zhang Huihuang Yin Guishan Chen Qingxia Huang Xiaoping Yang Lan Chen Chujia Lin Guoshu Yin |
| author_sort | Fu Chen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T03:44:25Z |
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| institution | Directory Open Access Journal |
| issn | 1757-2215 |
| language | English |
| last_indexed | 2024-04-11T03:44:25Z |
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| spelling | doaj.art-95a5e127bd384348b58449414d98d2632023-01-02T02:58:39ZengBMCJournal of Ovarian Research1757-22152021-02-011411910.1186/s13048-021-00781-5Comparison 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 PCOSFu Chen0Minjie Chen1Weichun Zhang2Huihuang Yin3Guishan Chen4Qingxia Huang5Xiaoping Yang6Lan Chen7Chujia Lin8Guoshu Yin9Department of Clinical Nutrition, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeDepartment of Endocrinology, The 1st Affiliated Hospital of Shantou University Medical CollegeAbstract 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.https://doi.org/10.1186/s13048-021-00781-5Polycystic ovary syndrome (PCOS)Dexamethasone suppression testAndrogenAdrenalLiquid chromatography-mass spectrometry (LC-MS/MS) |
| spellingShingle | Fu Chen Minjie Chen Weichun Zhang Huihuang Yin Guishan Chen Qingxia Huang Xiaoping Yang Lan Chen Chujia Lin Guoshu Yin 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 Polycystic ovary syndrome (PCOS) Dexamethasone suppression test Androgen Adrenal Liquid chromatography-mass spectrometry (LC-MS/MS) |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Polycystic ovary syndrome (PCOS) Dexamethasone suppression test Androgen Adrenal Liquid chromatography-mass spectrometry (LC-MS/MS) |
| url | https://doi.org/10.1186/s13048-021-00781-5 |
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