Hyperandrogenism in Women

Description

Hyperandrogenism profoundly affects women’s lives from lowering self-esteem to changing cognition and affective motivation. The polycystic ovary syndrome (PCOS) is the most common androgen excess disorder worldwide. While it is not the focus of this book, some aspects are discussed. The aim of this book is to improve understanding of androgen excess and its impact on several conditions. Topics include development of adipose tissue in females, insulin sensitivity, congenital adrenal hyperplasia, and Cushing’s disease/syndrome. There is also a discussion of PCOS with emphasis on in utero origins and specific genetic and epigenetic factors. This book provides a wealth of relevant information for every endocrinologist and gynecologist who wants to broaden their knowledge of androgens in various conditions.

Informations

• Publié par: S. Karger AG
• Date de parution: 09 septembre 2019
• Nombre de lectures: 0
• EAN13: 9783318064711
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Hyperandrogenism in Women
Frontiers of Hormone Research
Vol. 53
Series Editor
Ezio Ghigo Turin
Co-Editor
Federica Guaraldi Turin
 
Hyperandrogenism in Women
Beyond Polycystic Ovary Syndrome
Volume Editors
Renato Pasquali Bologna
Duarte Pignatelli Porto
24 figures, 12 in color, and 10 tables, 2019
Frontiers of Hormone Research Founded 1972 by Tj.B. van Wimersma Greidanus, Utrecht Continued by Ashley B. Grossman, Oxford (1996–2013)
_______________________ Prof. Renato Pasquali, MD Endocrinology and Reproduction University of Bologna Bologna (Italy)
_______________________ Duarte Pignatelli Department of Biomedicine Faculty of Medicine of the University of Porto Porto (Portugal)
Library of Congress Cataloging-in-Publication Data
Names: Pasquali, Renato, editor. | Pignatelli, Duarte, editor.
Title: Hyperandrogenism in women : beyond polycystic ovary syndrome / volume editors, Renato Pasquali, Duarte Pignatelli.
Description: Basel ; New York : Karger, 2019. | Series: Frontiers of hormone research, ISSN 0301-3073 ; vol. 53 | Includes bibliographical references and indexes.
Identifiers: LCCN 2019000165 (print) | LCCN 2019000859 (ebook) | ISBN 9783318064711 (eBook) | ISBN 9783318064704 (hard cover : alk. paper) | ISBN 978331806471 (e-ISBN)
Subjects: | MESH: Hyperandrogenism | Adrenocortical Hyperfunction | Women
Classification: LCC RG207.5 (ebook) | LCC RG207.5 (print) | NLM WK 770 | DDC 618.1--dc23
LC record available at https://lccn.loc.gov/2019000165
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and MEDLINE/Pubmed.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2019 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed on acid-free and non-aging paper (ISO 9706)
ISSN 0301–3073
eISSN 1662–3762
ISBN 978–3–318–06470–4
e-ISBN 978–3–318–06471–1
Contents
Foreword
Pasquali, R. (Bologna); Pignatelli, D. (Porto)
In utero Androgen Excess: A Developmental Commonality Preceding Polycystic Ovary Syndrome?
Abbott, D.H.; Kraynak, M. (Madison, WI); Dumesic, D.A. (Los Angeles, CA); Levine, J.E. (Madison, WI)
Androgens, Body Composition, and Their Metabolism Based on Sex
Giagulli, V.A.; Castellana, M. (Bari); Pelusi, C. (Bologna); Triggiani, V. (Bari)
Understanding the Role of Androgen Action in Female Adipose Tissue
Schiffer, L.; Arlt, W.; O’Reilly, M.W. (Birmingham)
The Role of Androgen Excess on Insulin Sensitivity in Women
Diamanti-Kandarakis, E.; Pappalou, O.; Kandaraki, E.A. (Athens)
Androgens in Congenital Adrenal Hyperplasia
Pignatelli, D.; Pereira, S.S. (Porto); Pasquali, R. (Bologna)
Androgens in Cushing’s Syndrome
Arnaldi, G.; Martino, M. (Ancona)
Hyperandrogenism and Adrenocortical Tumors
Di Dalmazi, G. (Bologna)
Androgen-Secreting Ovarian Tumors
Macut, D.; Ilić, D.; Mitrović Jovanović, A.; Bjekić-Macut, J. (Belgrade)
Endocrinology of Hirsutism: From Androgens to Androgen Excess Disorders
Yilmaz, B. (Izmir); Yildiz, B.O. (Ankara)
Obesity and Androgens in Women
Pasquali, R.; Oriolo, C. (Bologna)
Androgens in Menopausal Women: Not Only Polycystic Ovary Syndrome
Kostakis, E.K.; Gkioni, L.N. (Athens); Macut, D. (Belgrade); Mastorakos, G. (Athens)
Androgen Excess in Women: Proteomic and Metabolomic Approaches
Insenser, M.; Escobar-Morreale, H.F. (Madrid)
Androgens and Severe Insulin Resistance States: Basic and Clinical Aspects
Gambineri, A.; Zanotti, L.; Ibarra-Gasparini, D. (Bologna)
Author Index
Subject Index
 
Pasquali R, Pignatelli D (eds): Hyperandrogenism in Women. Beyond Polycystic Ovary Syndrome. Front Horm Res. Basel, Karger, 2019, vol 53, pp VII–VIII (DOI: 10.1159/000496415)
______________________
Foreword
Hyperandrogenism in women is a fascinating field of study that includes several different clinical and pathophysiological entities. It profoundly affects women’s lives from lowering their self-esteem to changing their cognition and their affective motivation, from affecting their strength to being responsible for infertility.
Undoubtedly, the polycystic ovary syndrome (PCOS) is the most common androgen excess disorder worldwide, and although this disorder is not the main focus of this book, some particular aspects are still discussed.
One relevant part of this book focuses on understanding the role of androgen excess on adipose tissue in females and on the mechanistic perspectives based on a developmental commonality preceding PCOS, with specific interest on in utero origins of this disorder and on specific genetic and epigenetic background. Some phenotypic and molecular convergence between highly related species suggests not only dual genetic and epigenetic contributions to a developmental origin of PCOS but also common molecular pathogenesis extending beyond humans.
Recent advances provided by proteomic and metabolomic studies have the potential advantage over genomics of integrating genetic and epigenetic influences, thereby facilitating the interpretation of the molecular mechanisms and pathways involved in the pathogenesis of PCOS. Therefore, these techniques have the potential advantage of integrating genetic and epigenetic influences, providing a global vision of the biological systems. Definitely, proteomics and metabolomics may provide great advantages compared with targeted approaches in the definition of key pathways of complex metabolic disorders such as PCOS or conditions of androgen excess related to adolescent obesity as well as adult obesity during the fertile age and even after menopause. Androgen excess may also negatively impact insulin sensitivity in women, as well as body composition and metabolism. These aspects are of great importance to understand the role of androgen excess in the development of different obesity phenotypes, in order to provide specific pathophysiological mechanisms related to the susceptibility to develop metabolic disorders, chiefly the metabolic syndrome and, particularly, type 2 diabetes.
In women, obesity per se may represent a condition of androgen excess, particularly if it develops during adolescence. For example, PCOS in adolescent girls may present in heterogenous ways, which may often lead to an excess of diagnosis and, above all, not to take into account the fact that the presence of obesity can, in itself, be associated with an excess of androgens of various origins (ovarian and/or adrenal). The concept that obesity in both adolescents as well as in young adult women, may be characterized by the presence of androgen excess which, in turn, may favor the development of metabolic disorders, should be considered a potential important factor favoring metabolic disorders later throughout the woman’s lifetime.
A specific condition in women is represented by the development of obesity and abdominal fatness, which is characterized by an increase in testosterone blood levels, secondary to chronic stress exposure in both adult and adolescent girls. Undoubtedly, it should merit much more attention by clinicians worldwide.
Intriguingly, there are serious arguments to support the concept that obesity contributes to the development of PCOS in susceptible individuals, as confirmed by the fact that sustained weight loss and its maintenance in the long term may lead to a total regression of the PCOS phenotype and the dysmetabolic profiles other than significant benefits of the reproductive function.
In women, there are many other disorders associated with androgen excess, which are often present in late adolescence or young adults. These include non-classic congenital adrenal hyperplasia, conditions of mild cortisol excess as well as adrenal adenomas, androgen secreting tumors (in these cases particularly during early menopausal years), as well as severe insulin-resistant states. These very important yet relatively uncommon endocrine disorders should be adequately understood and considered by clinicians before planning any therapeutic procedure.