Adrenal Hyperandrogenism and Polycystic Ovary Syndrome.

Abstract:

BACKGROUND:The prevalence of adrenal hyperandrogenism (AH), as defined by increased circulating dehydroepiandrosterone-sulfate (DHEAS) levels, ranges from 15 to 45% in women with polycystic ovary syndrome (PCOS). METHODS:The aim of this review is to update the pathogenesis and consequences of AH in PCOS, from molecular genetics to the clinical setting. RESULTS:Mounting evidence derived from animal models suggests that genetically or enviromentally determined prenatal androgen excess, by influencing the hormonal and metabolic phenotype of susceptible female fetuses later in life, may be the capital event for the development of AH in PCOS. Because human placental aromatase activity is likely to prevent any deleterious effect of maternal hyperandrogenemia on the fetus, inheritance of the maternal steroidogenic defect is the more likely culprit, even though other factors such as changes in placental steroidogenesis itself or its nutritional efflux may also be involved in the building a deregulated enzymatic pathway from utero to adult life. Anyhow, the most important issue is whether or not AH influences the cardiometabolic risk of women with PCOS. On the one hand, AH has shown a controversial relationship with carbohydrate metabolism and adiposity, and is also associated with abnormalities in blood pressure regulation in these patients. On the other hand, DHEAS may exert a beneficial effect on the lipid profile of both lean and obese patients. Lastly, available studies in women with PCOS cast doubt upon a protective role of DHEAS levels on subclinical atherosclerosis, despite opposite data from the general population. CONCLUSION:AH is frequent in patients with PCOS yet unraveling its consequences for the management of this disorder requires future longitudinal studies.

journal_name

Curr Pharm Des

authors

Luque-Ramírez M,Escobar-Morreale HF

doi

10.2174/1381612822666160720150625

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

5588-5602

issue

36

eissn

1381-6128

issn

1873-4286

pii

CPD-EPUB-77192

journal_volume

22

pub_type

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