Androgen sulfate and glucuronide conjugates in nonhirsute and hirsute women with polycystic ovarian syndrome

Abstract

Peripheral androgen action largely determines the occurrence of hirsutism in women. Although serum 5a·androstane-3a,17[3-diol (3a-diol) glucuronide signifies skin 5a-reductase activity and has been used as a marker of hirsutism and peripheral androgen metabolism, other C,g androgen conjugates have recently been measured and may also be useful markers of hirsutism in women. In addition to normal controls we studied both hirsute and non hirsute patients with polycystic ovarian syndrome who had similar levels of circulating androgen precursors. In these three groups we measured various C,g sulfates and glucuronides including serum 3a-diol glucuronide. Serum androgen precursors were elevated, but were equal in the hirsute and non hirsute patients. Serum androsterone sulfate and glucuronide, and 3a-diol sulfate and glucuronide clearly differentiated the hirsute from the nonhirsute group. Among the conjugates, androsterone glucuronide was most reflective of the difference between the two groups (100.3 ± 28.0 versus 42.9 ± 4.0 ng/ml, p < 0.05). In hirsute compared with nonhirsute patients with polycystic ovarian syndrome, serum 3a-diol glucuronide was increased by the smallest amount (32%), followed by androsterone sulfate (38%), 3a-diol sulfate (59%), and androsterone glucuronide with the largest increase (134%). Serum androsterone glucuronide and 3a-diol glucuronide both correlated with androstenedione and dehydroepiandrosterone sulfate in hirsute women but not in nonhirsute women. These data suggest that besides serum 3a-diol glucuronide, other C,g sulfate and glucuronide conjugates may reflect peripheral androgen action. (AM J OSSTET GVNECOL 1989;161 :1704-9.)