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Exp Clin Endocrinol Diabetes 2015; 123(01): 55-60
DOI: 10.1055/s-0034-1387735
Article
© Georg Thieme Verlag KG Stuttgart · New York

Atypical Polycystic Ovary Syndrome – A Genetic Analysis

M. Scholten
1   Department of Pediatrics, Jena University Hospital, Jena, Germany
,
C. Vilser
1   Department of Pediatrics, Jena University Hospital, Jena, Germany
,
A. Weise
2   Institute of Human Genetics, Jena University Hospital, Jena, Germany
,
A. Baniahmad
2   Institute of Human Genetics, Jena University Hospital, Jena, Germany
› Institutsangaben
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Publikationsverlauf

received 15. März 2014
first decision 20. Juni 2014

accepted 04. August 2014

Publikationsdatum:
22. August 2014 (online)

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Abstract

Background/aims: Although polycystic ovary syndrome (PCOS) is a common endocrinopathy the pathogenesis is not entirely understood. Typically, high androgen levels are associated with increased virilization. We report 2 rare groups of patients with either unexpectedly high testosterone levels despite low virilization as well as patients with low testosterone levels despite high grade of virilization. One possibility for the atypical PCOS may be based on an altered androgen receptor (AR) signaling.

Methods: 6 patients and when available the parents were included in this study. Alterations of the metaphase chromosomes by GTG staining, the length of both the trinucleotide CAG- and GGC-repeats of the androgen receptor (AR) gene was determined by PCR, further the entire AR gene was sequenced and analyzed.

Results: The GTG banding revealed no chromosomal alterations and the range of CAG- and GGC-repeat lengths are within the normal range. Interestingly, by sequencing of the entire AR gene few genetic mutations were identified.

Conclusion: The detected mutations do not alter the AR protein sequence but they change the codon usage towards less frequent codons that potentially may alter AR protein levels and androgen signaling. In addition to this, we postulate also other causes for manifestation of atypical PCOS, which may include AR-coregulators or epigenetic alterations. To our knowledge this is the first report of combining chromosomal analysis of PCOS patients with full sequencing of the human AR gene and linking codon usage to PCOS.

Key words

atypical PCOS - androgen levels - chromosome banding - androgen receptor gene sequencing - virilization
 

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