Androgen sulfate and glucuronide conjugates in nonhirsute and hirsute women with polycystic ovarian syndrome

Peripheral androgen action largely determines the occurrence of hirsutism in women. Although serum 5α-androstane-3α,17β-diol (3α-diol) glucuronide signifies skin 5α-reductase activity and has been used as a marker of hirsutism and peripheral androgen metabolism, other C 19 androgen conjugates have recently been measured and may also be useful markers of hirsutism in women. In addition to normal controls we studied both hirsute and nonhirsute patients with polycystic ovarian syndrome who had similar levels of circulating androgen precursors. In these three groups we measured various C 19 sulfates and glucuronides including serum 3α-diol glucuronide. Serum androgen precursors were elevated, but were equal in the hirsute and nonhirsute patients. Serum androsterone sulfate and glucuronide, and 3α-diol sulfate and glucuronide clearly differentiated the hirsute from the nonhirsute group. Among the conjugates, androsterone glucuronide was most reflective of the difference between the two groups (100.3 ± 28.0 versus 42.9 ± 4.0 ng/ml, p 19 sulfate and glucuronide conjugates may reflect peripheral androgen action.