{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:08:11Z","timestamp":1790316491506,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81200619"],"award-info":[{"award-number":["81200619"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Medical Scientific Research Foundation of Guangdong Province of China","doi-asserted-by":"crossref","award":["A2020390"],"award-info":[{"award-number":["A2020390"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Ovarian Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The aims of this study were to compare the efficacy of different androgens measured by liquid chromatography-mass spectrometry (LC-MS\/MS) in representing hyperandrogenemia and to evaluate adrenal-origin androgens with a dexamethasone suppression test in patients with polycystic ovary syndrome (PCOS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred and two patients with PCOS and 41 healthy volunteers were recruited and total serum testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were measured by LC-MS\/MS. ROC analysis was performed to compare the efficacy of different androgens in representing hyperandrogenemia. Dexamethasone suppression test was performed in 51 patients with PCOS and above indicators were measured after dexamethasone administration. The prediction efficacy of DHEA and DHEA-S at baseline in the dexamethasone suppression test was evaluated with ROC analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The AUCs of TT, AD, free androgen index (FAI) and DHEA-S in ROC analysis for representing hyperandrogenemia were 0.816, 0.842, 0.937 and 0.678, respectively. The optimal cutoff value of TT was 0.337\u2009ng\/ml, with a sensitivity of 72.0% and specificity of 82.93%. The optimal cutoff value for AD was 1.309\u2009ng\/ml, with a sensitivity of 81.0% and specificity of 73.17%. The optimal cutoff value of the FAI was 2.50, with a sensitivity of 87.0% and specificity of 92.68%. Alternatively, AD or FAI more than the optimal cutoff values as evidence of hyperandrogenemia had the highest sensitivity of 91.18%. The levels of cortisol, DHEA and DHEA-S were all suppressed to narrow ranges after dexamethasone administration. Nine and 8 of 51 patients with PCOS had significant decreases in TT and AD, respectively. DHEA can be used as a indicator for predicting significant decrease of TT in dexamethasone suppression test with cutoff value of 13.28\u2009ng\/ml<jats:bold>.<\/jats:bold> A total of 27.5% (14\/51) of patients had DHEA-S excess, but only 1 of 9 patients who had a significant decrease in TT had elevated level of DHEA-S at baseline.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>AD measured by LC-MS\/MS can represent hyperandrogenemia in PCOS patients and, combined with TT or FAI, can improve the screening efficiency of hyperandrogenemia. Seventeen percent of PCOS patients had adrenal-origin androgen dominance, with TT significantly decreasing after 2\u2009days of dexamethasone administration. Adrenal-origin androgen dominance was not parallel with DHEA-S excess in patients with PCOS.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13048-021-00781-5","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:06:42Z","timestamp":1613347602000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Comparison of the efficacy of different androgens measured by LC-MS\/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS"],"prefix":"10.1186","volume":"14","author":[{"given":"Fu","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weichun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihuang","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guishan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxia","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chujia","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoshu","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"issue":"5","key":"781_CR1","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1038\/nrendo.2018.24","volume":"14","author":"HF Escobar-Morreale","year":"2018","unstructured":"Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270\u201384.","journal-title":"Nat Rev Endocrinol"},{"issue":"6","key":"781_CR2","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1093\/humupd\/dmy022","volume":"24","author":"MA Skiba","year":"2018","unstructured":"Skiba MA, Islam RM, Bell RJ, Davis SR. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(6):694\u2013709.","journal-title":"Hum Reprod Update"},{"issue":"3","key":"781_CR3","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1210\/jc.2013-3399","volume":"99","author":"MW O'Reilly","year":"2014","unstructured":"O'Reilly MW, Taylor AE, Crabtree NJ, et al. Hyperandrogenemia predicts metabolic phenotype in polycystic ovary syndrome: the utility of serum androstenedione. J Clin Endocrinol Metab. 2014;99(3):1027\u201336.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"781_CR4","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1210\/jc.2014-1307","volume":"99","author":"BG Keevil","year":"2014","unstructured":"Keevil BG. How do we measure hyperandrogenemia in patients with PCOS. J Clin Endocrinol Metab. 2014;99(3):777\u20139.","journal-title":"J Clin Endocrinol Metab"},{"issue":"36","key":"781_CR5","doi-asserted-by":"publisher","first-page":"5588","DOI":"10.2174\/1381612822666160720150625","volume":"22","author":"M Luque-Ram\u00edrez","year":"2016","unstructured":"Luque-Ram\u00edrez M, Escobar-Morreale HF. Adrenal Hyperandrogenism and polycystic ovary syndrome. Curr Pharm Des. 2016;22(36):5588\u2013602.","journal-title":"Curr Pharm Des"},{"key":"781_CR6","doi-asserted-by":"crossref","unstructured":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41\u20137.","DOI":"10.1093\/humrep\/deh098"},{"issue":"4","key":"781_CR7","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1055\/s-0031-1299765","volume":"120","author":"D Racho\u0144","year":"2012","unstructured":"Racho\u0144 D. Differential diagnosis of hyperandrogenism in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes. 2012;120(4):205\u20139.","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"12","key":"781_CR8","doi-asserted-by":"publisher","first-page":"4565","DOI":"10.1210\/jc.2013-2350","volume":"98","author":"RS Legro","year":"2013","unstructured":"Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565\u201392.","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"781_CR9","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1002\/cphy.c140006","volume":"4","author":"A Turcu","year":"2014","unstructured":"Turcu A, Smith JM, Auchus R, Rainey WE. Adrenal androgens and androgen precursors-definition, synthesis, regulation and physiologic actions. Compr Physiol. 2014;4(4):1369\u201381.","journal-title":"Compr Physiol"},{"issue":"3\u20135","key":"781_CR10","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.jsbmb.2007.09.015","volume":"108","author":"WE Rainey","year":"2008","unstructured":"Rainey WE, Nakamura Y. Regulation of the adrenal androgen biosynthesis. J Steroid Biochem Mol Biol. 2008;108(3\u20135):281\u20136.","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"4","key":"781_CR11","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s11154-007-9054-0","volume":"8","author":"BO Yildiz","year":"2007","unstructured":"Yildiz BO, Azziz R. The adrenal and polycystic ovary syndrome. Rev Endocr Metab Disord. 2007;8(4):331\u201342.","journal-title":"Rev Endocr Metab Disord"},{"issue":"9","key":"781_CR12","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1016\/j.steroids.2006.05.005","volume":"71","author":"SA Doi","year":"2006","unstructured":"Doi SA, Al-Zaid M, Towers PA, Scott CJ, Al-Shoumer KA. Steroidogenic alterations and adrenal androgen excess in PCOS. Steroids. 2006;71(9):751\u20139.","journal-title":"Steroids."},{"issue":"10","key":"781_CR13","first-page":"2039","volume":"62","author":"CS Knudsen","year":"2016","unstructured":"Knudsen CS, Hoejskov CS, Moller HJ, Nexo E. Testosterone measured with an automatic immunoassay compares reasonably well to results obtained by LC-MS\/MS. Clin Lab. 2016;62(10):2039\u201343.","journal-title":"Clin Lab"},{"issue":"3","key":"781_CR14","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/cen.12086","volume":"78","author":"IR Wallace","year":"2013","unstructured":"Wallace IR, McKinley MC, Bell PM, Hunter SJ. Sex hormone binding globulin and insulin resistance. Clin Endocrinol. 2013;78(3):321\u20139.","journal-title":"Clin Endocrinol"},{"issue":"4","key":"781_CR15","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1530\/EC-17-0051","volume":"6","author":"T Reinehr","year":"2017","unstructured":"Reinehr T, Kulle A, Rothermel J, et al. Longitudinal analyses of the steroid metabolome in obese PCOS girls with weight loss. Endocr Connect. 2017;6(4):213\u201324.","journal-title":"Endocr Connect"},{"issue":"9","key":"781_CR16","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1093\/humrep\/dey243","volume":"33","author":"A Gunness","year":"2018","unstructured":"Gunness A, Pazderska A, Ahmed M, et al. Measurement of selected androgens using liquid chromatography-tandem mass spectrometry in reproductive-age women with type 1 diabetes. Hum Reprod. 2018;33(9):1727\u201334.","journal-title":"Hum Reprod"},{"key":"781_CR17","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jsbmb.2014.06.003","volume":"145","author":"MO Goodarzi","year":"2015","unstructured":"Goodarzi MO, Carmina E, Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol. 2015;145:213\u201325.","journal-title":"J Steroid Biochem Mol Biol"},{"key":"781_CR18","doi-asserted-by":"crossref","unstructured":"Alpa\u00f1\u00e9s M, Luque-Ram\u00edrez M, Mart\u00ednez-Garc\u00eda M\u00c1, Fern\u00e1ndez-Dur\u00e1n E, \u00c1lvarez-Blasco F, Escobar-Morreale HF. Influence of adrenal hyperandrogenism on the clinical and metabolic phenotype of women with polycystic ovary syndrome. Fertil Steril. 2015;103(3):795\u2013801.e2.","DOI":"10.1016\/j.fertnstert.2014.12.105"},{"key":"781_CR19","doi-asserted-by":"crossref","unstructured":"Keevil B. Steroid Mass Spectrometry for the Diagnosis of PCOS. Med Sci (Basel). 2019;7(7).","DOI":"10.3390\/medsci7070078"},{"key":"781_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsbmb.2015.01.006","volume":"149","author":"AY Dury","year":"2015","unstructured":"Dury AY, Ke Y, Gonthier R, Isabelle M, Simard JN, Labrie F. Validated LC-MS\/MS simultaneous assay of five sex steroid\/neurosteroid-related sulfates in human serum. J Steroid Biochem Mol Biol. 2015;149:1\u201310.","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"Pt 6","key":"781_CR21","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1258\/000456305774538175","volume":"42","author":"CA Chadwick","year":"2005","unstructured":"Chadwick CA, Owen LJ, Keevil BG. Development of a method for the measurement of dehydroepiandrosterone sulphate by liquid chromatography-tandem mass spectrometry. Ann Clin Biochem. 2005;42(Pt 6):468\u201374.","journal-title":"Ann Clin Biochem"},{"issue":"6","key":"781_CR22","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1111\/j.1365-2265.2005.02256.x","volume":"62","author":"A Kumar","year":"2005","unstructured":"Kumar A, Woods KS, Bartolucci AA, Azziz R. Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS). Clin Endocrinol. 2005;62(6):644\u20139.","journal-title":"Clin Endocrinol"},{"issue":"3","key":"781_CR23","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1210\/jc.2014-2569","volume":"100","author":"C Moran","year":"2015","unstructured":"Moran C, Arriaga M, Arechavaleta-Velasco F, Moran S. Adrenal androgen excess and body mass index in polycystic ovary syndrome. J Clin Endocrinol Metab. 2015;100(3):942\u201350.","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"781_CR24","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1210\/jc.2016-3285","volume":"102","author":"MW O'Reilly","year":"2017","unstructured":"O'Reilly MW, Kempegowda P, Jenkinson C, et al. 11-oxygenated C19 steroids are the predominant androgens in polycystic ovary syndrome. J Clin Endocrinol Metab. 2017;102(3):840\u20138.","journal-title":"J Clin Endocrinol Metab"},{"key":"781_CR25","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.bcp.2015.10.010","volume":"102","author":"SS Udhane","year":"2016","unstructured":"Udhane SS, Fl\u00fcck CE. Regulation of human (adrenal) androgen biosynthesis-new insights from novel throughput technology studies. Biochem Pharmacol. 2016;102:20\u201333.","journal-title":"Biochem Pharmacol"},{"issue":"7","key":"781_CR26","first-page":"2317","volume":"83","author":"R Azziz","year":"1998","unstructured":"Azziz R, Black V, Hines GA, Fox LM, Boots LR. Adrenal androgen excess in the polycystic ovary syndrome: sensitivity and responsivity of the hypothalamic-pituitary-adrenal axis. J Clin Endocrinol Metab. 1998;83(7):2317\u201323.","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"781_CR27","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1530\/eje.0.1470473","volume":"147","author":"R Colak","year":"2002","unstructured":"Colak R, Kele\u015ftimur F, Unl\u00fchizarci K, Bayram F, Sahin Y, Tutu\u015f A. A comparison between the effects of low dose (1 microg) and standard dose (250 microg) ACTH stimulation tests on adrenal P450c17alpha enzyme activity in women with polycystic ovary syndrome. Eur J Endocrinol. 2002;147(4):473\u20137.","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"781_CR28","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1111\/j.1365-2265.1994.tb03010.x","volume":"40","author":"KH Polderman","year":"1994","unstructured":"Polderman KH, Gooren LJ, van der Veen EA. Testosterone administration increases adrenal response to adrenocorticotrophin. Clin Endocrinol. 1994;40(5):595\u2013601.","journal-title":"Clin Endocrinol"},{"issue":"3","key":"781_CR29","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1093\/humrep\/deh103","volume":"19","author":"E Vanky","year":"2004","unstructured":"Vanky E, Salvesen KA, Carlsen SM. Six-month treatment with low-dose dexamethasone further reduces androgen levels in PCOS women treated with diet and lifestyle advice, and metformin. Hum Reprod. 2004;19(3):529\u201333.","journal-title":"Hum Reprod"},{"key":"781_CR30","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.4158\/EP15748.DSC","volume":"21","author":"NF Goodman","year":"2015","unstructured":"Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E. American association of clinical endocrinologists, American college of endocrinology, and androgenn excess and PCOS society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome-part 1. Endocr Pract. 2015;21:1291\u2013300.","journal-title":"Endocr Pract"}],"container-title":["Journal of Ovarian Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13048-021-00781-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13048-021-00781-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13048-021-00781-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:11:08Z","timestamp":1613347868000},"score":1,"resource":{"primary":{"URL":"https:\/\/ovarianresearch.biomedcentral.com\/articles\/10.1186\/s13048-021-00781-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,14]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["781"],"URL":"https:\/\/doi.org\/10.1186\/s13048-021-00781-5","relation":{},"ISSN":["1757-2215"],"issn-type":[{"value":"1757-2215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,14]]},"assertion":[{"value":"30 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Ethics Committee of the First Affiliated Hospital Shantou University Medical College according to the Council for International Organizations of Medical Sciences. Written informed consent was obtained from all participants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}