MedWire News: Study findings suggest that high levels of serum dehydroepiandrosterone sulfate (DHEAS) in women with polycystic ovary syndrome (PCOS) are associated with phenotypic acne, independent of testosterone levels and insulin resistance (IR).
DHEAS has been shown to be associated with the presence of acne, and have an influence on the risk for obesity, IR, and metabolic disturbances, although findings in women with hyperandrogenism and PCOS have been inconsistent.
This "might reflect a lack of consideration of the interactive confounding effect from testosterone in most of the [previous] studies," say Yu-Shih Yang (National Taiwan University Hospital, Taipei) and co-authors.
For the current study, the researchers measured body mass index (BMI), waist circumference, waist-to-hip ratio, lipid profiles, fasting glucose, insulin levels, and hormone profiles in 318 untreated Taiwanese women with PCOS.
In total, 38.7% of women exhibited phenotypic acne. Compared with women without acne, they were significantly younger (22.9 vs 25.5 years), had higher DHEAS levels (6.01 vs 4.87 µmol/l), and a lower BMI (23.4 vs 25.7 kg/m2).
DHEAS levels were positively correlated with testosterone levels, but inversely related to waist circumference, waist-to-hip ratio, BMI, IR index, and levels of low-density lipoprotein cholesterol and triglyceride.
Women with higher DHEAS levels were more likely to have phenotypic acne, affecting 53.2% of women in the highest quartile of DHEAS (≥6.68 nmol/l) versus 33.7% of those in the lowest quartile (<3.34 nmol/l). Furthermore, having DHEAS levels in the highest quartile was associated with a 2.15-fold increased risk for phenotypic acne after adjusting for age and BMI.
In contrast, women with high DHEAS levels in the highest quartile had the lowest risk for abdominal obesity, after adjustment for age, IR, dyslipidemia, testosterone, and estradiol levels.
Women with PCOS and elevated total testosterone levels (≥2.78 nmol/l) had significantly higher levels of DHEAS than women with lower total testosterone levels (5.89 vs 4.21 µmol/l), but total testosterone levels did not significantly differ among women with or without acne.
"The inverse relationship between obesity and acne in women with PCOS can be partially explained by the negative association between serum DHEAS concentration and obesity, regardless of age and testosterone level," say the researchers in journal Human Reproduction.
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