1st-order laboratory parameters-obligatory laboratory tests.
- LH, FSH [often there is increased LH/FSH quotient > 1]
- Prolactin [low serum prolactin level is considered a risk marker for metabolic risk]
- Testosterone*
- DHEAS*
- SHBG* *
- Androstenedione
- Plasma insulin
- Oral glucose tolerance test (oGTT)* * *
* Definition of hyperandrogenemia: total testosterone level > 2.08 nmol/l or as serum dehydroepiandrostenedione sulfate (DHEA-S) level > 6.6 mol/l) and/or features of hyperandrogenism such as hirsutism, acne (e.g. acne vulgaris), seborrhea.
* * SHBG (sexual hormone binding globulins) is the main serum transport protein for testosterone. Production site is the liver; production rate is influenced by insulin. In the presence of elevated testosterone and insulin serum levels, the synthesis (formation) of SHBG is suppressed, especially in obese patients. One study indicates that there is an increased risk of developing insulin resistance when serum SHBG levels are decreased (predictive marker for insulin resistance).
* * * Patients with PCO syndrome are considered a high-risk group for metabolic disorders. A 75-oGTT (oral glucose tolerance test) should therefore be performed as a screening procedure in the sense of primary prevention of type 2 diabetes mellitus and repeated at 3-5 year intervals.
Laboratory parameters of the 2nd order – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification
- 21-Hydroxylase (because of 21-hydroxylase-deficient nonclassical adrenal hyperplasia).
