The relationship of ovarian-adrenal steroid hormones with phenotypic and clinical features in women with polycystic ovarian syndrome

Aim: In our study, we aimed to evaluate the relationship between phenotypic features and ovarian and adrenal steroid hormones in women with polycystic ovary syndrome. Materialand Methods: Fifty patients with PCOS (obese-overweight/non-obese: 21/29, mean age 22 (18-39) years) were included in the study. After physical examination and anthropometric measurements of all volunteers, the menstrual cycle is 2-5. Ovarian and adrenal steroid hormones, lipid profiles and levels were studied from serum samples taken between 8-10 hours after days. Steroid hormones were analyzed by liquid chromatography sequential mass spectrophotometry (LC-MS/MS) method. Results: Patients diagnosed with PCOS were found to have a positive correlation with body mass index (BMI) and cholesterol, low density lipoprotein (LDL), triglyceride (TG) values (p=0.003 p=0.001 p=0.002, respectively). It was determined that the arm circumference of the patients showed positive correlation with cholesterol, LDL and TG values. (p=0.004 p=0.008 p=0.001). In the comparison between women considered normal weight according to BMI and overweight-obese women, Estron, 17-OH Pregnenolone, DHT, 1,4 Delta Androstenedion, DHEAS levels were higher in the group with overweight-obese and there was no statistically significant difference. Free Testosterone levels of overweight-obese patients were higher than normal weight patients and this was statistically significant. (P=0.037) DHEAS, free Testosterone Estron, 17-OH pregnenolone levels were higher in the group with menstrual irregularities no difference was observed. Patients with menstrual irregularities had higher levels of DHT, 1,4 Delta Androstenedione and Total Testosterone compared to other patients, which was statistically significant (p=0.021 p=0.010 p = 0.049, respectively). When patients diagnosed with PCOS are examined according to the absence of hirsutism, Pregnenolone, Corticosterone, 11-Deoxycorticosterone, Estron, 17-OH Pregnenolone, DHT, DHEA, Aldosterone, 1,4 Delta Androstenedione, 17-OH Progesterone, DHEAS, Free Testosterone and Total Testosterone there was no statistically significant difference in the levels. Androsterone levels of patients without hirsutism were higher than patients with hirsutism, and this was statistically significant.(p=0,024) It was found that Ferr-Gal score did not correlate with steroid hormone findings. Conclusion: In our study, free testosterone, Dehydroepiandrosterone sulfate, low density lipoprotein, cholesterol and triglyceride values were found high and significant in the group with high body mass index in patients with PCOS. There was no correlation between the biochemical findings of patients with hirsutism and hirsutism. We can say that obesity and insulin resistance treatment still maintains its importance in the treatment of PCOS, and that laboratory findings alone do not make sense in histutism approach and treatment modulation. Since PCOS is a multifactorial disease, more comprehensive research is needed, including genetic factors, laboratory findings, and enzyme studies. Keywords: PCOS, Steroid hormones, obesity, hirsutism, LC-MS/MS