Dehydroepiandrosterone sulfate/free androgen index ratio predicts a favorable metabolic profile in patients with polycystic ovary syndrome

Abstract

Potential effect of hyperandrogenemia on metabolic disturbances in polycystic ovary syndrome (PCOS) has always been a matter of interest. We analyzed the records of 125 patients with PCOS and 54 age-matched healthy women. All participants underwent biochemical and hormonal assessment and a 75 g oral glucose tolerance test was performed. PCOS and control groups were comparable in terms of age. Dehydroepiandrosterone sulfate/free androgen index (DHEAS/FAI) ratio was negatively correlated with body mass index (BMI) (p < .001), fasting glucose (p = .02), area under the curve (AUC) of glucose (p = .03), AUC of insulin (p = .001), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (p < .001), and triglycerides (TG) (p = .009), and positively correlated with insulin sensitivity index (ISI) (p < .001) and high-density lipoprotein cholesterol (HDL-C) (p < .001) among PCOS patients. In logistic regression analysis, higher DHEAS/FAI ratio levels were associated with lower risk of low HDL-C [RR(95%CI); 0.97(0.95–0.98); p < .001] as well as atherogenic dyslipidemia (TG/HDL-C) [RR(95%CI); 0.97(0.94–0.99); p = .035] even after adjustment for BMI in the PCOS group. Androgens, DHEAS and FAI act differently on metabolic parameters. Our results demonstrate that high DHEA-S/FAI ratio levels are associated with a more favorable metabolic profile.

摘要

高雄激素血症对多囊卵巢综合征（PCOS）代谢紊乱的潜在影响一直是人们关注的问题。我们分析了125名PCOS患者和54名年龄匹配的健康女性的病历。所有受试者接受生化和激素评估以及75g口服葡萄糖耐量试验。PCOS和对照组的年龄是相当的。PCOS患者中硫酸脱氢表雄酮/游离雄激素指数（DHEAS/FAI）比值与体质指数（BMI）（p<.001）、空腹血糖（p=.02）、葡萄糖曲线下面积（AUC）（p=.03）、胰岛素AUC（p=.001）、稳态模型胰岛素抵抗指数（HOMA-IR）（p<.001）和甘油三酯（TG）（p=.009）呈负相关, 与胰岛素敏感指数（ISI）（p<.001）和高密度脂蛋白（HDL-C）（p<.001）呈正相关。Logistic回归分析中, 即使校正了PCOS组的BMI后, 较高的DHEAS/FAI指数水平与低HDL-C[RR(95%CI); 0.97(0.95–0.98); p<.001]和致动脉粥样硬化性血脂异常（TG/HDL-C）[RR(95%CI); 0.97(0.94–0.99); p=.035]风险降低相关。雄激素、DHEAS和FAI对代谢参数的作用不同。我们的结果证明, 高DHEA-S/FAI 比值水平与更好的代谢特征相关。

Keywords:

• Polycystic ovary syndrome (PCOS)
• dehydroepiandrosterone sulfate (DHEAS)
• free androgen index (FAI)
• triglyceride (TG)
• high-density lipoprotein cholesterol (HDL-C)

Disclosure statement

No potential conflict of interest was reported by the authors.