Presentations of Hyperandrogenic Phenotypes in Taiwanese Women
STUDY QUESTION: Which of the four abnormally elevated androgen groups (total testosterone [TT], androstenedione [A4], free androgen index [FAI], or dehydroepiandrosterone-sulfate [DHEA-S]) present with an unfavorable metabolic and hormonal profile, appear to be more insulin-resistant and pose additional cardiovascular risk? SUMMARY ANSWER: Subjects with excess free androgen index tend to be obese and face the highest metabolic syndrome risk, adipocytokine alterations, insulin resistance (IR) and cardiovascular risk. The excess TT group presents with a marginal IR risk, while the excess A4 group has the highest antimüllerian hormone (AMH), and may counterbalance obesity; this group and the excess DHEA-S group have a favorable association with IR.
Polycystic Ovary Syndrome,
|Study Design:||Observational Model: Case Control
Time Perspective: Retrospective
|Official Title:||Clinical and Biochemical Presentations of Distinctive Types of Biochemical Hyperandrogenism in Premenopausal Taiwanese Women|
- Clinical and Biochemical Presentations of Distinctive Types of Biochemical Hyperandrogenism in Premenopausal Taiwanese Women [ Time Frame: A retrospective study in 160 Taiwanese women with HA and 165 women without HA, with medical records reviewed from January 1, 2009, through July 21, 2012 (up to 3.5 years) ] [ Designated as safety issue: No ]Androgens (Total Testosterone (TT) (nmol/L), androstenedione (A4)(ng/ml), free androgen index (FAI), and dehydroepiandrosterone sulfate (DHEA-S) (µg/dl ); anthroponmetric components (body mass index (BMI)(Kg/m2) , waist (cm), Waist-to-hip ratio (W/H)); average menstrual interval, antimullerian hormone(AMH)(ng/ml) adiponectin (ng/nl), leptin(ng/ml), adiponectin/leptin (A/L) ratio, and insulin resistance markers( fasting insulin (µIU/ml), glucose-to-insulin ratio (GIR), Homeostasis model assessment insulin resistance (HOMA-IR) Index, Lipid Accumulation Product Index (LAP Index)).
|Study Start Date:||September 2012|
|Study Completion Date:||July 2013|
|Primary Completion Date:||March 2013 (Final data collection date for primary outcome measure)|
patients who have all androgens (TT, A4, FAI, and DHEA-S) lower than their cut-off values
Total Testosterone >= 2.39
Patients who have only total testosterone higher than its cut-off value; (TT) >=2.39
Androstenedione >= 2.99
Patients who have only androstenedione higher than its cut-off value; (A4) >=2.99
Free Androgen Index >= 6.53
Patients who have only free androgen index higher than its cut-off value; (FAI) >=6.53
DHEAs >= 181.55
Patients who have only dehyroepiandrosterone sulfate higher than its cut-off value; (DHEA-S)>=181.55
STUDY DESIGN, SIZE, DURATION:A retrospective study in 160 Taiwanese women with HA and 165 women without HA, with medical records reviewed from 2009 up to 2012. The hyperandrogenic women were classified into four groups (TT, A4, FAI, and DHEA-S) according to independent abnormally elevated androgen measures each above its cut-off value, and the groups were compared with each other and with controls.
PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was performed in the Reproductive Endocrinology Clinic at Wan Fang Medical Center in Taipei, Taiwan. Anthropometric, metabolic, endocrine, and IR components as well as lipid accumulation product (LAP) index were compared between the groups. IR was assessed with the following markers: fasting glucose and insulin levels, oral glucose tolerance test, glucose-to-insulin ratio and homeostasis model assessment of IR index (HOMA-IR).
|WanFang Medical Center at Taipei Medical University|
|Taipei, Taiwan, 116|
|Principal Investigator:||Ming I Hsu, MD||WanFang Medical Center at Taipei Medical University|