Vol 88, No 1 (2017)
Research paper
Published online: 2017-01-31

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Total testosterone to dihydrotestosterone ratio assessed by LC-MS/MS predicts a worse metabolic profile not only in PCOS patients

Urszula Ambroziak, Alina Kuryłowicz, Anna Kępczyńska-Nyk, Zbigniew Bartoszewicz, Agnieszka Kondracka, Radosław Jaźwiec, Emilia Samborowska, Michał Dadlez, Aleksandra Wysłouch-Cieszyńska, Tomasz Bednarczuk
Pubmed: 28157253
Ginekol Pol 2017;88(1):5-8.


Objectives: Total testosterone/dihydrotestosterone ratio (TT/DHT) was found to determine metabolic risk in polycystic ovary syndrome (PCOS). The aim of this study was to analyze whether (TT/DHT) may be helpful in predicting metabolic risk not only in PCOS patients but also in healthy women.

Material and methods: Total testosterone (TT), dihydrotestosterone (DHT), androstendione and dehydroepiandrosterone sulphate (DHEA-S) were measured by LC-MS/MS in 36 women with PCOS and in 29 age-matched controls without clinical hyperandrogenism. In all participants, anthropometric data, lipids, adipose tissue percent (%fat), HOMA-IR were also assessed.

Results: The studied groups were not different in terms of age, BMI, waist circumference, %fat and HOMA-IR. In the patients group, mean TT and androstendione levels were significantly higher as compared to controls (1.4 nmol/L vs. 1.0 nmol/L, P < 0.001) and (6.6 nmol/L vs. 4.9 nmol/L, P < 0.01), respectively. In the patients group, mean TT/DHT ratio was significantly higher compared to controls (3.6 vs. 2.7, P < 0.01) and correlated with BMI (r = 0.37, P < 0.05), waist circumference (r = 0.44, P < 0.01), %fat (r = 0.30, P < 0.05), as well as with insulin levels (r = 0.38, P < 0.05) and HOMA-IR (r = 0.44, P < 0.05). The association between TT/DHT ratio and unfavorable metabolic parameters was also seen in controls.

Conclusion: Total testosterone/dihydrotestosterone ratio assessed by LC-MS/MS correlates with a worse metabolic profile not only in PCOS patients, but also in healthy women.


  1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril. 2004; 81(1): 19–25.
  2. Randeva HS, Tan BK, Weickert MO, et al. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr. Rev. 2012; 33(5): 812–841.
  3. Mani H, Levy MJ, Davies MJ, et al. Diabetes and cardiovascular events in women with polycystic ovary syndrome: a 20-year retrospective cohort study. Clin. Endocrinol. (Oxf). 2013; 78(6): 926–934.
  4. Münzker J, Hofer D, Trummer C, et al. Testosterone to dihydrotestosterone ratio as a new biomarker for an adverse metabolic phenotype in the polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2015; 100(2): 653–660.
  5. Shroff R, Syrop CH, Davis W, et al. Risk of metabolic complications in the new PCOS phenotypes based on the Rotterdam criteria. Fertil. Steril. 2007; 88(5): 1389–1395.
  6. Stanczyk FZ, Clarke NJ. Advantages and challenges of mass spectrometry assays for steroid hormones. J. Steroid Biochem. Mol. Biol. 2010; 121(3-5): 491–495.
  7. Honour JW. 17-Hydroxyprogesterone in children, adolescents and adults. Ann. Clin. Biochem. 2014; 51(Pt 4): 424–440.
  8. Ambroziak U, Kępczyńska-Nyk A, Kuryłowicz A, et al. LC-MS/MS improves screening towards 21-hydroxylase deficiency. Gynecol. Endocrinol. 2015; 31(4): 296–300.
  9. FERRIMAN D, GALLWEY JD. Clinical assessment of body hair growth in women. J. Clin. Endocrinol. Metab. 1961; 21: 1440–1447.
  10. Koal T, Schmiederer D, Pham-Tuan H, et al. Standardized LC-MS/MS based steroid hormone profile-analysis. J. Steroid Biochem. Mol. Biol. 2012; 129(3-5): 129–138.
  11. Ollila MME, Piltonen T, Puukka K, et al. Weight Gain and Dyslipidemia in Early Adulthood Associate With Polycystic Ovary Syndrome: Prospective Cohort Study. J. Clin. Endocrinol. Metab. 2016; 101(2): 739–747.
  12. Valderhaug TG, Hertel JK, Nordstrand N, et al. The association between hyperandrogenemia and the metabolic syndrome in morbidly obese women. Diabetol Metab Syndr. 2015; 7: 46.
  13. Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum. Reprod. Update. 2009; 15(4): 477–488.
  14. Li H, Xu X, Wang X, et al. Free androgen index and Irisin in polycystic ovary syndrome. J. Endocrinol. Invest. 2016; 39(5): 549–556.
  15. Akin F, Bastemir M, Kaptanoglu B. Relationship between insulin and sex hormone-binding globulin levels during weight loss in obese women. Ann. Nutr. Metab. 2007; 51(6): 557–562.
  16. Lerchbaum E, Schwetz V, Rabe T, et al. Hyperandrogenemia in polycystic ovary syndrome: exploration of the role of free testosterone and androstenedione in metabolic phenotype. PLoS ONE. 2014; 9(10): e108263.