Androgens During the Reproductive Years: What Is Normal for Women?
Androgens During the Reproductive Years: What Is Normal for Women?
复制标题
DOI：
10.1210/jc.2019-01357
复制
发表时间：
2019-11-01
影响因子：
5.8
通讯作者：
Davis, Susan R.
中科院分区：
文献类型：
--
作者：
Skiba, Marina A.;Bell, Robin J.;Davis, Susan R.
目的：血清雄激素水平是否能识别“雄激素不足”或“雄激素过多”尚未得到解决；因此，什么构成“正常”仍不确定。我们试图确定包括11-氧合C19类固醇在内的雄激素在生殖年中是否会随着年龄、月经周期或体重指数(BMI)而变化。设计和背景：从澳大利亚东部各州招募的横断面研究。参与者：总共588名年龄在18到39岁之间的妇女，她们没有怀孕、哺乳或使用全身激素治疗，有规律的月经周期，也没有被诊断为多囊卵巢综合征。主要观察指标：用液相色谱-串联质谱仪测定性类固醇。结果：在月经周期中期和黄体期，睾酮和雄烯二酮的浓度显著高于卵泡早期、黄体期和卵泡期中位数分别为0.34nmo1/L(0.04~1.01)和1.97nmo1/L(0.53~7.89)。脱氢表雄酮(DHEA；4.91nmol/L，范围0.08~23.51)、11-酮雄烯二酮(11kA；7.99nmol/L；范围0.07~31.67)、11-酮睾酮(11kt；1.27nmol/L，范围0.03~7.61)未见周期性变化。超重女性的中位数睾酮(P<；0.05)、脱氢表雄酮(DHEA)(P<；0.05)和11KA(P<；0.01)水平均低于正常体重女性。35~39岁组C19类固醇水平显著低于18~25岁组(P<；0.01)。在调整BMI和周期后，11kA/雄烯二酮(4.3：1)和11kT/睾酮(3.9：1)比值的中位数没有随年龄变化。结论：11kA和11kT在整个月经周期中是稳定的，对循环雄激素池有重要的数量贡献。所有C19雄激素在绝经前随着年龄的增长而下降；因此，需要年龄特定的参考范围来解释绝经前妇女的雄激素水平。
Objective: Whether serum androgen levels can identify women with "androgen insufficiency" or "androgen excess" is unresolved; thus, what constitutes "normal" remains uncertain. We sought to determine whether androgens, including 11-oxygenated C19 steroids, vary with age, menstrual cycle, or body mass index (BMI), during the reproductive years.Design and Setting: Cross-sectional study recruited from eastern Australian states.Participants: A total of 588 women, aged 18 to 39 years, who were not pregnant, lactating, or using systemic hormone therapy, with regular menstrual cycles and no previous diagnosis of polycystic ovarian syndrome.Main Outcome Measures: Sex steroids measured using liquid chromatography-tandem mass spectrometry.Results: Testosterone and androstenedione concentrations were significantly higher during the menstrual cycle mid- and luteal phases than in the early follicular phase, with median values across the cycle of 0.34 nmol/L (range, 0.04 to 1.01) and 1.97 nmol/L (range, 0.53 to 7.89), respectively. No cyclical variations were found in dehydroepiandrosterone (DHEA; 4.91 nmol/L; range, 0.08 to 23.51), 11-ketoandrostenedione (11KA; 7.99 nmol/L; range, 0.07 to 31.67), or 11-ketotestosterone (11KT; 1.27 nmol/L; range, 0.03 to 7.61). Overweight women had lower median testosterone (P < 0.05), DHEA (P < 0.05), and 11KA (P < 0.01) levels than normal-weight women. All C19 steroids were significantly lower (P < 0.01) in those aged 35 to 39 years than in those aged 18 to 25 years. The median 11KA/androstenedione (4.3:1) and 11KT/testosterone (3.9:1) ratios did not change with age, after adjustment for BMI and cycle stage.Conclusions: We have demonstrated that 11KA and 11KT are stable across the menstrual cycle and make major quantitative contributions to the circulating androgen pool. All C19 androgens declined with age before menopause; hence, age-specific reference ranges are required for the interpretation of androgen levels in premenopausal women.