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Human Reproduction, Vol. 10, No. 2, pp. 299-303, 1995
© 1995 European Society of Human Reproduction and Embryology

research-article

Endocrinology: Substrate dependency of C19 conjugates in hirsute hyperandrogenic women and the influence of adrenal androgen

E. Carmina1, E. Gentzschein2, F.Z. Stanczyk2 and R.A. Lobo2,3

1Cattedra di Endocrinologia, Universita di Palermo Palermo, Italy 2Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California School of Medicine Los Angeles, CA, USA

Correspondence: 3To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Women's and Children's Hospital, Room 1M2, 1240 North Misison Road, Los Angeles, CA 90033, USA

Serum C19 conjugates, specifically 3{alpha}-androstanediol glucuronide (3{alpha}G), reflect peripheral androgen action through the action of 5{alpha}-reductase activity. The origin of 5{alpha}-reduced C19 conjugates has been controversial and it has been suggested that they are derived primarily from adrenal androgens. We examined concentrations of 3{alpha}G, 3{alpha}-androstanediol sulphate (3{alpha}S), androsterone glucuronide (AoG) and androsterone sulphate (AoS) in 40 hirsute hyperandrogenic women. These patients were divided into four groups based upon individual, combined or normal concentrations of the adrenal androgens dehydroepiandrosterone (DHEAS) and 11{beta}-hydroxy-androstenedione. Testosterone, unbound testosterone and androstenedione were similar in these groups. Serum 3{alpha}G was equally high in all groups and was correlated significantly with hirsutism, while the other conjugates were not. Androsterone glucuronide was raised in all groups but was higher in patients with raised DHEAS. Serum 3{alpha}S was raised in all groups and was higher where both adrenal androgens were raised. Serum AoS was highly correlated with DHEAS. Serum 3{alpha}G was correlated with unbound testosterone and androstenedione but not with the adrenal androgens. The glucuronide conjugates were correlated with one another as were the sulphate conjugates but glucuronides and sulphates were not correlated. These data confirm ovarian and adrenal dependency of C19 conjugates. Serum 3{alpha}G appears to reflect hirsutism most accurately and is least dependent on adrenal androgens in patients with mixed hyperandrogenism.

Key words: adrenal/C19 conjugates/hirsutism/ovarian


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