Prostate specific antigen (PSA) in diagnosis of polycystic ovarian syndrome – a new insight

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder and cause of androgen excess in women. Prostate specific antigen (PSA) could be a new marker of hyperandrogenism in PCOS.

Objective: The aim of the study was to assess the concentration PSA (total PSA - TPSA and free PSA - fPSA) in 165 patients with PCOS and 40 healthy female controls, the relationship between PSA (TPSA and fPSA) and hormonal parameters and to determine the performance of PSA in diagnosis of PCOS.

Results: Total PSA was higher in PCOS group versus controls. The fPSA was below the lower detection levels among all patients. The median value of FAI was 4.31 in PCOS patients versus 1.79 in controls, p < 0.001. There was a correlation of TPSA and tT (r= 0.173, p = 0.027) and TPSA and FAI (r = 0.2603, p = 0.001). AUC for FAI was 82.1%, threshold 2.56 nmol/l, for tT AUC 80.5%, threshold 0.54 ng/ml, for TPSA AUC 66.3%, threshold 0.005 ng/ml. The ROC analysis for A AUC 62.7%, threshold 3.95 ng/ml.

Conclusion: PCOS women have higher serum concentration of TPSA than controls. TPSA positively correlate with T and FAI, which is the best marker for hyperandrogenic states and has better accuracy for tT and total PSA serum levels in diagnostic of PCOS.

Chinese abstract

引言: 多囊卵巢综合征 (polycystic ovary syndrome, PCOS) 是女性最常见的内分泌疾病, 原因在于雄激素分泌过多。前列腺特异抗原 (prostate specific antigen, PSA) 可作为PCOS高雄激素血症新的标记物。

目的: 本研究的目的是评估165名PCOS患者和40名健康对照女性的PSA浓度 (总PSA-TPSA和游离PSA-fPSA) 和激素指标, 确定PSA在PCOS诊断中的表现。

结果: PCOS组总PSA高于对照组。所有患者的fPSA低于最低检测水平。PCOS的FAI中值为4.31, 对照组为1.79, p＜0.001。TPSA和tT相关 (r = 0.173, p = 0.027) , TPSA和FAI相关 (r = 0.2603, p = 0.001) 。FAI的曲线下面积为82.1%, 临界值为2.56 nmol/l, tT的曲线下面积为80.5%, 临界值为0.54 ng/ml, TPSA曲线下面积为66.3%, 临界值为0.005 ng/ml, ROC曲线分析雄烯二酮的曲线下面积为62.7%, 临界值为3.95 ng/ml。

结论: PCOS女性血清TPSA浓度高于对照组。TPSA与T和FAI呈正相关, FAI是高雄激素状态的最佳标记物, 在诊断PCOS中较血清tT和总PSA准确度更高。

Keywords:

• Hyperandrogenism
• polycystic ovary syndrome
• prostate specific antigen
• testosterone

Acknowledgements

Our sincere thanks goes to Michal Kunicki, MD, PhD, for his insightful comments and substantive support.

Declaration of interest

The authors report no declarations of interest.