ABSTRACT
Background Hyperandrogenemic polycystic ovary syndrome (PCOS) may have occult corticosteroidogenic enzyme abnormalities. The current study compares the activities of 11ß-hydroxylase between normoandrogenemic PCOS (NA-PCOS) and hyperandrogenemic PCOS (HA-PCOS) phenotypes. Materials and methods Anthropometric, and biochemical variables were compared between normal cycling women [n = 272] and those with PCOS [n = 453]; either normoandrogenemic [n = 98] or hyperandrogenemic [n = 355]. Univariate and multivariate logistic regression analyses were performed using 11ß-hydroxylase enzyme activity as the criterion variable. Results 11ß-Hydroxylase enzyme activity tended to be slightly higher in both PCOS subgroups and did not change with ethnicity. Using univariate logistic regression, 11ß-hydroxylase activity in controls was associated with dehydroepiandrosterone, insulin, homeostatic model for insulin resistance (HOMA-IR), and high-density lipoprotein cholesterol (HDL-C). In NA-PCOS women the activity of 11ß-hydroxylase was associated with estradiol (E2), androstenedione (A4), and androstenedione/dehydroepiandrosterone ratio; in the hyperandrogenemic (HA-PCOS) group, 11ß-hydroxylase activity associated with sex-hormone binding globulin (SHBG), 17-hydroxypregnenolone (17-OHPE), fasting glucose, and ß-cell activity. After multivariate logistic regression, androstenedione/dehydroepiandrosterone ratio, and ß-cell activity were the best predictors of 11ß-hydroxylase activity in controls; in NA-PCOS group only androstenedione/dehydroepiandrosterone ratio was confirmed as a significant predictor of 11ß-hydroxylase activity, and in HA-PCOS patients, 17-OHPE and ß-cell activity demonstrated to be significant predictors. Conclusions 11ß-Hydroxylase activity was equal in different ethnicities. The prevalence of decreased 11ß-hydroxylase activity was higher in the HA-PCOS phenotype. 17-OHPE, and ß-cell function are significant predictors of 11ß-hydroxylase activity in HA-PCOS subjects. These findings may help to identify which PCOS patient would have benefit in measuring 11-deoxycortisol (compound S) and 11ß-hydroxylase enzyme activity.
