Comparison of Clinical and Biochemical Markers of Hirsutism in Polycystic Ovary Syndrome – A Study from a Teaching Hospital in Sri Ramachandra Institute, Chennai, India

Abstract

BACKGROUND We wanted to analyse the clinical profile of polycystic ovarian syndrome (PCOS) women with history, examination and ultrasonogram and correlate hirsutism with biochemical markers as free testosterone, dehydro-epiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG), free testosterone, DHEAS, and SHBG. METHODS This study is a prospective observational study conducted from 2011 to 2013 in the Department of Obstetrics and Gynaecology, Shree Balaji Medical College and Hospital, Chrompet in patients attending Gynaecology OPD. 100 women visiting the OPD were taken as control and 100 women were taken for PCOS study. RESULTS Hyperandrogenism was studied and all the biochemical markers were significantly higher in polycystic ovarian syndrome patients than in controls (P < 0.0001). The highest AUC-ROC was found for bioavailable testosterone (0.852) followed by free androgen index (0.847) and free testosterone (0.837). Lower AUC-ROC was found for androstenedione, total testosterone and SHBG (0.706, 0.799 and 0.76, respectively). When free androgen index of 4.97 was taken as a cut off value, sensitivity was 71.4 % and specificity was 85.2 %. A cut off of 0.78 nmol / L for bioavailable testosterone had even higher sensitivity of 75.9 %, but slightly lower specificity of 83.3 %. Bioavailable testosterone and free androgen index correlated significantly (all P < 0.05) with DHEAS, LH / FSH ratio, androstenedione and total testosterone. In addition, bioavailable testosterone, free androgen index, and free testosterone correlated significantly with follicle count, ovarian volume, and hirsutism scores. CONCLUSIONS White women have about 20 % of excess of dehydro-epiandrosterone sulphate (DHEAS) and black women have 30 % excess of dehydro-epiandrosterone sulphate (DHEAS) in those having poly cystic ovaries patients. There is an age-associated decline in DHEAS levels which is similar in both control and poly cystic ovaries women, regardless of the race which was seen in this study. KEY WORDS Free Testosterone, Dehydro–Epiandrosterone Sulphate (DHEAS), Sex Hormone Binding Globulin (SHBG)