Correlation between Serum Dehydroepiandrosterone Sulfate and LDL Cholesterol in Patients with Polycystic Ovarian Syndrome

Hantoro Gunawan, Irvan Ipandi, Jusak Nugraha, Ashon Sa'adi


Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrine disorder in female of childbearing age. PCOS patients also have metabolic and cardiovascular disorder risks. One of the factors that can affect those disorders is androgen hormone level. Dehydroepiandrosterone, is produced by the adrenal gland, and its metabolite dehydroepiandrosterone sulphate (DHEAS) has a different effect than testosterone. DHEA and DHEAS might have a protective effect to dyslipidemia and cardiovascular disorder. LDL cholesterol is an important parameter for dyslipidemia therapy guide according to The National Cholesterol Education Program Adult Treatment Panel. The aim of this study was to analyze the correlation between DHEAS and LDL cholesterol.

This research was a cross sectional observational study. DHEAS and LDL cholesterol were examined in 25 research subjects by chemiluminescent immunoassay (Immulite®, Siemens) and colorimetric enzymatic (Dimension EXL®, Siemens). These subjects were divided into 3 groups according to 2003 Rotterdam’s criteria. Spearman and Pearson’s correlation statistical analysis were done, with a significance of p-value less than 0.05

This study showed a moderate negative correlation between DHEAS and LDL cholesterol (r= -0.441, p = 0.027). Group D PCOS (non-hyperandrogenic) had a strong negative correlation between DHEAS and LDL cholesterol (r=-0.717, p= 0.001). DHEA, in some literatures was shown to activate Peroxisome Proliferator Activated Response γ (PPAR γ) receptors and thereby increasing LDL-cholesterol receptors in adipose tissue and LDL-cholesterol uptake from serum. The rise in DHEAS might indicate a better prognosis for PCOS patients in terms of cardiovascular complications, especially in group D PCOS.


Dehydroepiandrosterone sulfate, low-density lipoprotein cholesterol, polycystic ovarian syndrome

Full Text:



Santoso B. Sindroma ovarium polikistik: Problem

reproduksi dan tantangannya terkait gaya hidup. Unair

repository. Surabaya, Airlangga University Press,


(accessed 14 December, 2019).

Cussons AJ, Watts GF, Burke V, Shaw JE, Zimmet PZ,

Stuckey B. Cardiometabolic risk in polycystic ovary

syndrome: A comparison of different approaches to

defining the metabolic syndrome. Human

Reproduction, 2008; 23(10): 2352-2358.

Rizzo M. Long-term consequences of polycystic ovary

syndrome on cardiovascular risk. Fertility and Sterility,

; 91(4): 1563-1567.

Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in

polycystic ovary syndrome: Systematic review and

meta-analysis. Fertility and Sterility, 2011; 95(3):


C h r i s t o d o u l a k i C , P e r g i a l i o t i s V .

Dehydroepiandrosterone-sulfate, insulin resistance,

and ovarian volume estimation in patients with

polycystic ovarian syndrome. Journal of Family and

Reproductive Health, 2017; 11(1): 24-29.

Köşüş N, Köşüş A, Kamalak Z, Hizli D, Turhan NÖ.

Impact of adrenal versus ovarian androgen ratio on

signs and symptoms of polycystic ovarian syndrome.

Gynecological Endocrinology, 2012; 28(8): 611-614.

Simoncini T, Mannella P, Fornari L, Varone G, Caruso A,

et al. Dehydroepiandrosterone modulates endothelial

nitric oxide synthesis via direct genomic and

nongenomic mechanisms. Endocrinology, 2003;

(8): 3449-3455.

Mannic T, Viguie J, Rossier MF. In-vivo and in-vitro

evidences of dehydroepiandrosterone protective role

on the cardiovascular system. International Journal of

Endocrinology and Metabolism, 2015; 13(2): 1-5.

Chen M, Chen C, Yang J, Chen C, Ho H, et al. High

serum dehydroepiandrosterone sulfate is associated

with phenotypic acne and a reduced risk of abdominal

obesity in women with polycystic ovary syndrome.

Hum. Reprod, 2011; 26: 219-220.

Brennan K, Huang A, Azziz R. Dehydroepiandrosterone

sulfate and insulin resistance in patients with

polycystic ovary syndrome. Fertility and Sterility, 2009;

(5): 1848-1852.

Grundy S, Berker D, Clark L, Cooper R. Third Report of

the National Cholesterol Education Program (NCEP)

Expert panel on detection, evaluation, and treatment

of high blood cholesterol in adults (adult treatment

panel III). NIH Publication, 2002; 2: 3-4.

Wiweko B, Indra I, Susanto C, Natadisastra M,

Hestiantoro A. The correlation between serum AMH

and HOMA IR among PCOS phenotypes. BMC

Research Notes, 2018; 1: 1-6.

Huang Z, Yong E. Ethnic differences: Is there an Asian

phenotype for polycystic ovarian syndrome?. Best

Practice & Research Clinical Obstetrics &

Gynaecology, 2016; 2: 1-28.

Rojas J, Chávez M, Olivar L, Rojas M, Morillo J, et al.

Polycystic ovary syndrome, insulin resistance, and

obesity: Navigating the pathophysiologic labyrinth.

International Journal of Reproductive Medicine, 2014;

: 1-17.

Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S.

Comparison of the different PCOS phenotypes based

on clinical metabolic, and hormonal profile, and their response to clomiphene. Indian J Endocr and Metab,

; 23: 326-331.

Chui, PC, Guan H, Lehrke M, Lazar MA. PPAR g

regulates adipocyte cholesterol metabolism via

oxidized LDL receptor 1. Journal of Clinical

Investigation, 2005; 115(8): 2244-2256.

Hennings C, Kurzman I, Haffa A, Kemnitz J,

Macewen E. The effect of high-fat diet and

dehydroepiandrosterone (DHEA) administration

in the rhesus monkey. In-Vivo, 1995; 5: 415-420.

Lasco A, Frisina N, Morabito N, Gaudio A, Morini E,

et al. Metabolic effects of dehydroepiandrosterone

replacement therapy in post-menopausal women.

European Journal of Endocrinology, 2001; 145: 457-461.

Lerchbaum E, Schwetz V, Giuliani A, Pieber TR.

Opposing effects of dehydroepiandrosterone sulfate

and free testosterone on metabolic phenotype in

women with polycystic ovary syndrome. Fertility and

Sterility, 2012; 98(5): 1318-1325.e1.

Gambineri A, Vicennati V, Genghini S, Tomassoni F,

Pagotto U, et al. Genetic variation in 11

B-hydroxysteroid dehydrogenase type 1 predicts

adrenal hyperandrogenism among lean women with

polycystic ovary syndrome. The Journal of Clinical

Endocrinology & Metabolism, 2006; 91(6): 2295-23.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.