Münzker J, Lindheim L, Adaway J, Trummer C, Lerchbaum E, Pieber T R, Keevil B, Obermayer-Pietsch B
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Manchester Academic Health Science Centre, Department of Clinical Chemistry, University Hospital South Manchester, Manchester, UK.
Clin Endocrinol (Oxf). 2017 Apr;86(4):567-575. doi: 10.1111/cen.13299. Epub 2017 Jan 23.
Polycystic ovary syndrome (PCOS) is characterized by a combination of hormonal and metabolic disturbances, such as insulin resistance, glucose intolerance, anovulation and hyperandrogenism. Clinical phenotypes of PCOS show different patterns of steroid hormones that have been investigated to some extent. This study aimed to establish a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of salivary testosterone and androstenedione and to describe the salivary testosterone-to-androstenedione (T/A4) ratio as a new tool for the assessment of hyperandrogenism and metabolic health.
Saliva and serum samples of 274 patients with PCOS and 51 healthy women were used for the quantification of steroid hormones. A comprehensive clinical and metabolic assessment was performed. Salivary testosterone and androstenedione were measured via LC-MS/MS. The salivary T/A4 ratio was calculated and correlated with hormones and metabolic parameters.
Salivary testosterone (P < 0·001), androstenedione (P < 0·001) and the salivary T/A4 ratio (P < 0·001) were significantly higher in patients with patients compared to healthy women. In patients with PCOS, a high salivary T/A4 ratio was associated with an adverse metabolic phenotype, that is glucose intolerance (P = 0·019), insulin resistance (P < 0·001), metabolic syndrome (P < 0·001), obesity (P < 0·001) and oligo-/anovulation (P = 0·001). Significant correlations of the salivary T/A4 ratio with adverse metabolic parameters were found.
Quantification of salivary androgens provides an attractive alternative to serum analysis and helps in characterizing metabolic health in women with PCOS. Our data show a strong link between a high salivary T/A4 ratio and an adverse metabolic phenotype in patients with PCOS.
多囊卵巢综合征（PCOS）的特征是激素和代谢紊乱并存，如胰岛素抵抗、葡萄糖不耐受、无排卵和高雄激素血症。PCOS的临床表型显示出不同模式的甾体激素，对此已进行了一定程度的研究。本研究旨在建立一种液相色谱-串联质谱（LC-MS/MS）方法，用于定量唾液睾酮和雄烯二酮，并将唾液睾酮与雄烯二酮的比值（T/A4）描述为评估高雄激素血症和代谢健康的一种新工具。
收集274例PCOS患者和51例健康女性的唾液和血清样本，用于甾体激素定量。进行了全面的临床和代谢评估。通过LC-MS/MS测定唾液睾酮和雄烯二酮。计算唾液T/A4比值，并将其与激素和代谢参数进行关联分析。
与健康女性相比，PCOS患者的唾液睾酮（P < 0.001）、雄烯二酮（P < 0.001）和唾液T/A4比值（P < 0.001）显著更高。在PCOS患者中，高唾液T/A4比值与不良代谢表型相关，即葡萄糖不耐受（P = 0.019）、胰岛素抵抗（P < 0.001）、代谢综合征（P < 0.001）、肥胖（P < 0.001）和少/无排卵（P = 0.001）。发现唾液T/A4比值与不良代谢参数之间存在显著相关性。
唾液雄激素定量为血清分析提供了一种有吸引力的替代方法，有助于表征PCOS女性的代谢健康状况。我们的数据显示，PCOS患者高唾液T/A4比值与不良代谢表型之间存在密切联系。
