Медицинский вестник Юга России (Sep 2022)
Gas chromatography-mass spectrometry based steroid metabolomics in women with different phenotypes of polycystic ovarian syndrome and normal body weight
Abstract
Objective: to study the steroid metabolomics in women with normal body weight and various PCOS phenotypes by gas chromatography-mass spectrometry (GC-MS). Materials and methods: forty-eight(48)women with PCOS aged 25±0,3 yearswith a BMI less than 25 kg/m2 were examined. The control group (CG) consisted of twenty-five (25) healthy women aged 26±0,6 years with a BMI of 23 (21-24) kg/m2. Immunoassays were used to determine the levels of hormones in serum. Urinary steroid profiles (USP) were studied by GC-MS method. Statistical data processing was performed using the software system STATISTICA for WINDOWS (ver. 10). Results: the article provides an analysis of the metabolism of androgens, glucocorticoids and progestogens in women with different phenotypes of polycystic ovary syndromeaccording to gas chromatography-mass spectrometry. Summary: the urinary excretion of androstenedione metabolites was increased in PCOS patients with androgen excess and anovulation (A and B phenotypes), dehydroepiandrosterone metabolites - in PCOS patients with androgen excess (A, B and C phenotypes). PCOS women with phenotype C showed raised urinary excretion of 11-oxo-pregnanetriol, pregnanetriol and 17-hydroxypregnanolone, a decrease in the ratios of the sum of tetrahydro derivatives of cortisol and cortisone to these progestogens, as well as determination of tetrahydro-21-deoxycorticol and nonclassical 5-ene-pregnenes according to GC-MS data. In fact, it indicated to deficiency of the 21-hydroxylase enzyme in these patients. It was found PCOS patients with androgen excess (A, B and C phenotypes) had the signs of insufficient 3β-hydroxysteroid dehydrogenase activity. PCOS women with phenotype A were revealed deficiency of 11β-hydroxysteroid dehydrogenase (type 1).
Keywords