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Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS)

  • Eleftherios P. Diamandis EMAIL logo , Frank Z. Stanczyk , Sarah Wheeler , Anu Mathew , Martin Stengelin , Galina Nikolenko , Eli N. Glezer , Marshall D. Brown , Yingye Zheng , Yen-Hao Chen , Hsiao-Li Wu and Ricardo Azziz
Published/Copyright: March 31, 2017
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 11

Abstract

Background:

Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS.

Methods:

We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth- generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA.

Results:

cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-to-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-the-receiver-operating-characteristic curve of 0.89.

Conclusions:

Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.

Keywords: androgen-regulated genes; hirsutism; hyperandrogenism; polycystic ovarian syndrome; prostate specific antigen; serum biomarkers; urine biomarkers
Corresponding author: Eleftherios P. Diamandis, MD, PhD, FRCP(C), FRSC, Head of Clinical Biochemistry, Mount Sinai Hospital and University Health Network, 60 Murray St. Box 32, Floor 6, Rm L6-201, Toronto, ON, M5T 3L9, Canada, Phone: +(416) 586-8443

  1. Author contributions: EPD conceived and designed the study and wrote the manuscript with help from all the co-authors. FZS participated in patient selection. SW, AM, MS, EG and GN participated in PSA sample analysis. MDB and YZ performed the statistical analysis and YHC; HW and RA participated in patient selection. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This research was supported by the Partnership for Clean Competition.

  3. Employment or leadership: RA is on the advisory board of Global PET and a consultant to KinDex Pharmaceuticals; SH, AM, MS, GN and ENG are employees of Meso Scale; the remaining authors have no conflicts of interest to declare.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: 10.1515/cclm-2016-1124) offers supplementary material, available to authorized users.

Received: 2016-12-9
Accepted: 2017-2-21
Published Online: 2017-3-31
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2016-1124
Keywords for this article
androgen-regulated genes; hirsutism; hyperandrogenism; polycystic ovarian syndrome; prostate specific antigen; serum biomarkers; urine biomarkers

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. High-sensitivity assays for cardiac troponins – continued
  4. Reviews
  5. The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications
  6. Vitamin B1 in critically ill patients: needs and challenges
  7. Opinion Papers
  8. Point
  9. High-sensitivity cardiac troponin: do think twice, it’s not all right
  10. Counterpoint
  11. Terminology of cardiac troponin assays and data censoring
  12. Establishing consensus-based, assay-specific 99th percentile upper reference limits to facilitate proper utilization of cardiac troponin measurements
  13. Fast track protocols using highly sensitive troponin assays for ruling out and ruling in non-ST elevation acute coronary syndrome
  14. Genetics and Molecular Diagnostics
  15. Relationship between polymorphisms in the CRP, LEP and LEPR genes and high sensitivity C-reactive protein levels in Spanish children
  16. General Clinical Chemistry and Laboratory Medicine
  17. An approach for estimating measurement uncertainty in medical laboratories using data from long-term quality control and external quality assessment schemes
  18. Selecting multi-rule quality control procedures based on patient risk
  19. Moving sum of number of positive patient result as a quality control tool
  20. Multidisciplinary training activities for decreasing preanalytical mistakes in samples from primary care
  21. Harmonization protocols for TSH immunoassays: a multicenter study in Italy
  22. Circulating free light chain measurement in the diagnosis, prognostic assessment and evaluation of response of AL amyloidosis: comparison of Freelite and N latex FLC assays
  23. Serum prolactin revisited: parametric reference intervals and cross platform evaluation of polyethylene glycol precipitation-based methods for discrimination between hyperprolactinemia and macroprolactinemia
  24. Temporal and regional variability in the request of vitamin D from general practitioners in Spain
  25. Fibrinogen determination according to Clauss: commutability assessment of International and commercial standards and quality control samples
  26. Reference Values and Biological Variations
  27. S100B maternal blood levels are gestational age- and gender-dependent in healthy pregnancies
  28. Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population
  29. Cancer Diagnostics
  30. Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS)
  31. Cardiovascular Diseases
  32. A new immunochemistry platform for a guideline-compliant cardiac troponin T assay at the point of care: proof of principle
  33. Diabetes
  34. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus: a cohort study
  35. Letters to the Editor
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  37. Automated detection of unstable hemoglobin variants by Sysmex XE-Series analyzers
  38. Mean hemoglobin concentrations in fasting venous and non-fasting capillary blood of Cambodian women using a hemoglobinometer and an automated hematology analyzer
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  41. Evaluation of a human anti-mouse antibody rapid test for patients requiring radio-immunodiagnostic
  42. The cortisol-CBG ratio affects cortisol immunoassay bias at elevated CBG concentrations
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  44. Use of IFCC guidelines to verify acetylcholinesterase reference interval in adults determined with ChE check mobile testing system
  45. Congress Abstracts
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