Assessing the androgenic and metabolic heterogeneity in polycystic ovary syndrome using cluster analysis.
Autor: | Deshmukh H; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK.; Department of Academic Diabetes and Endocrinology, Hull York Medical School, University of Hull, Hull, UK., Akbar S; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK., Bhaiji A; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK., Saeed Y; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK., Shah N; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK.; Department of Academic Diabetes and Endocrinology, Hull York Medical School, University of Hull, Hull, UK., Adeleke K; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK., Papageorgiou M; Faculty of Medicine, University of Geneva, Geneva, Switzerland., Atkin S; School Postgraduate Studies and Research, RCSI Bahrain, Adliya, Bahrain., Sathyapalan T; Department of Academic Diabetes and Endocrinology, Allam Diabetes Center Hull University Teaching Hospitals NHS Trust, Hull, UK.; Department of Academic Diabetes and Endocrinology, Hull York Medical School, University of Hull, Hull, UK. |
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Jazyk: | angličtina |
Zdroj: | Clinical endocrinology [Clin Endocrinol (Oxf)] 2023 Mar; Vol. 98 (3), pp. 400-406. Date of Electronic Publication: 2022 Nov 20. |
DOI: | 10.1111/cen.14847 |
Abstrakt: | Introduction: Some but not all women with polycystic ovary syndrome (PCOS) develop the metabolic syndrome (MS). The objective of this study was to determine if a subset of women with PCOS had higher androgen levels predisposing them to MS and whether routinely measured hormonal parameters impacted the metabolic syndrome score (siMS). Methods: We included data from a discovery (PCOS clinic data) and a replication cohort (Hull PCOS Biobank) and utilized eight routinely measured hormonal parameters in our clinics (free androgen index [FAI], sex hormone-binding globulin, dehydroepiandrosterone sulphate (DHEAS), androstenedione, luteinizing hormone [LH], follicular stimulating hormone, anti-Müllerian hormone and 17 hydroxyprogesterone [17-OHP]) to perform a K-means clustering (an unsupervised machine learning algorithm). We used NbClust Package in R to determine the best number of clusters. We estimated the siMS in each cluster and used regression analysis to evaluate the effect of hormonal parameters on SiMS. Results: The study consisted of 310 women with PCOS (discovery cohort: n = 199, replication cohort: n = 111). The cluster analysis identified two clusters in both the discovery and replication cohorts. The discovery cohort identified a larger cluster (n = 137) and a smaller cluster (n = 62), with 31% of the study participants. Similarly, the replication cohort identified a larger cluster (n = 74) and a smaller cluster (n = 37) with 33% of the study participants. The smaller cluster in the discovery cohort had significantly higher levels of LH (7.26 vs. 16.1 IU/L, p < .001), FAI (5.21 vs. 9.22, p < .001), androstenedione (3.93 vs. 7.56 nmol/L, p < .001) and 17-OHP (1.59 vs. 3.12 nmol/L, p < .001). These findings were replicated in the replication cohort. The mean (±SD) siMS score was higher in the smaller cluster, 3.1 (±1.1) versus 2.8 (±0.8); however, this was not statistically significant (p = .20). In the regression analysis, higher FAI (β = .05, p = .003) and androstenedione (β = .03, p = .02) were independently associated with a higher risk of SiMS score, while higher DHEAS levels were associated with a lower siMS score (β = -.07, p = .03) CONCLUSION: We identified a subset of women in our PCOS cohort with significantly higher LH, FAI, and androstenedione levels. We show that higher levels of androstenedione and FAI are associated with a higher siMS, while higher DHEAS levels were associated with lower siMS. (© 2022 John Wiley & Sons Ltd.) |
Databáze: | MEDLINE |
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