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. 2025 Sep 4;14(17):6246.
doi: 10.3390/jcm14176246.

Stimulated Hyperinsulinemia Is Independently Associated with Higher Serum DHEAS in PCOS: A Retrospective Study

Nicoleta Baculescu  1   2 , Serban Radian  1   2 , Dana Manda  3 , Cristina Georgiana Serban  1 , Dan Alexandru Niculescu  1   2 , Monica Livia Gheorghiu  1   2 , Florin Grigorescu  4 , Catalina Poiana  1   2
Affiliations

Stimulated Hyperinsulinemia Is Independently Associated with Higher Serum DHEAS in PCOS: A Retrospective Study

Nicoleta Baculescu et al. J Clin Med. .

Abstract

Background/Objectives: Increased dehydroepiandrosterone sulfate (DHEAS) is used as a diagnostic marker of hyperandrogenism in women with polycystic ovary syndrome (PCOS). The mechanisms of adrenal hyperandrogenism in PCOS include hyperinsulinism as a potential stimulator, but results of studies associating insulinemia with DHEAS in PCOS are conflicting. The objective of this study was to evaluate the factors associated with DHEAS levels in PCOS, focusing on insulinemia. Methods: We performed a cross-sectional retrospective study in a total of 257 patients with PCOS (Rotterdam criteria) evaluated in our tertiary center of endocrinology. Clinical and biochemical parameters included body mass index (BMI), serum DHEAS, total testosterone and sex hormone-binding globulin (SHBG), insulin and glycaemia at fasting and 2 h during the oral glucose tolerance test (OGTT), and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. Results: The comparative analysis of PCOS divided into DHEAS tertiles revealed that patients in the upper tertile were younger (p < 0.05) and had higher 2 h insulin in the OGTT (p < 0.05) than the lower tertile, while fasting insulin and HOMA-IR were not different. DHEAS correlated negatively with age (r = -0.146, p < 0.05) and positively with 2 h insulinemia (r = 0.246, p < 0.001), while fasting insulin and HOMA-IR did not correlate with DHEAS in all PCOS. In stepwise linear regression models, 2 h insulin remained a positive independent predictor for DHEAS only in non-obese PCOS (p < 0.0001). Conclusions: Our data indicate a positive association between stimulated insulin and DHEAS in PCOS. Two-hour insulin in OGTT was an independent predictor of DHEAS in non-obese PCOS, suggesting that DHEAS might be a reliable marker for the stimulatory insulin effect on adrenal steroidogenesis in non-obese PCOS patients.

Keywords: DHEAS; PCOS; adrenal hyperandrogenism; hyperinsulinemia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram representing the selection of PCOS subjects for the study.
See this image and copyright information in PMC

References

    1. Dapas M., Dunaif A. Deconstructing a Syndrome: Genomic Insights into PCOS Causal Mechanisms and Classification. Endocr. Rev. 2022;43:927–965. doi: 10.1210/endrev/bnac001. - DOI - PMC - PubMed
    1. Carmina E., Stanczyk F.Z., Chang L., Miles R.A., Lobo R.A. The Ratio of Androstenedione:11 Beta-Hydroxyandrostenedione Is an Important Marker of Adrenal Androgen Excess in Women. Fertil. Steril. 1992;58:148–152. doi: 10.1016/S0015-0282(16)55152-8. - DOI - PubMed
    1. Yoshida T., Matsuzaki T., Miyado M., Saito K., Iwasa T., Matsubara Y., Ogata T., Irahara M., Fukami M. 11-Oxygenated C19 Steroids as Circulating Androgens in Women with Polycystic Ovary Syndrome. Endocr. J. 2018;65:979–990. doi: 10.1507/endocrj.EJ18-0212. - DOI - PubMed
    1. Tosi F., Villani M., Garofalo S., Faccin G., Bonora E., Fiers T., Kaufman J.-M., Moghetti P. Clinical Value of Serum Levels of 11-Oxygenated Metabolites of Testosterone in Women With Polycystic Ovary Syndrome. J. Clin. Endocrinol. Metab. 2022;107:e2047–e2055. doi: 10.1210/clinem/dgab920. - DOI - PubMed
    1. Kempegowda P., Melson E., Manolopoulos K.N., Arlt W., O’Reilly M.W. Implicating Androgen Excess in Propagating Metabolic Disease in Polycystic Ovary Syndrome. Ther. Adv. Endocrinol. Metab. 2020;11:2042018820934319. doi: 10.1177/2042018820934319. - DOI - PMC - PubMed

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