Endocrine Abstracts

JOINT140611

Introduction: A novel interest in 11-oxygenated adrenal androgens (11-ketotestosterone, 11KT; 11-hydroxytestosterone, 11OHT; 11-ketoandrostenedione, 11KA4; and 11-hydroxyandrostenedione, 11OHA4) has emerged due to their contribution to androgen signaling through binding androgen receptors or as precursor metabolites. These androgens are predominantly produced by the adrenal gland, although evidence on enzyme distribution suggests that the androgens may be interconverted in peripheral tissues. A recent article investigating the association between adrenal androgens and contraceptive use found no association, albeit with a smaller sample size and combined contraceptive users rather than investigating combined hormonal contraceptives and gestagen containing contraceptives individually. A well-known effect of combined hormonal contraceptives is lowering of serum concentrations of testosterone, which is utilized for instance in treatment of polycystic ovary syndrome.

Material and methods: This study utilized data from the Fit Futures Study, a population-based longitudinal study following participants from adolescence into adulthood through three waves performed in 2010–2011 and 2012–2013, and the most recent third held in 2021–2022. The study was composed of questionnaires, clinical interview, physical examinations, and sampling of biological material. Specifically, this study utilized data from the third Fit Future study, in which 705 participants attended. Descriptive statistics were used to describe distributions of 11-oxygenated androgens. Independent t-tests and chi-square tests were used to compare variables between the sexes. Relation to exposure variables were assessed through independent t-tests or Pearson correlations and general linear models.

Results: The study included 305 males and 350 females with mean age of 26.9 (1.1). Males had 13–17% higher concentrations of 11-oxygenated androgens. Among the females, 32.6% used combined hormonal contraceptives, 11.7% used gestagen containing contraceptives, and 55.7% used non-hormonal contraceptives or no contraceptives. Gestagen containing contraceptives was found to have no association with 11-oxygenated androgens and was hence combined with non-hormonal contraceptives. Users of combined hormonal contraceptives had significantly lower levels of 11-ketotestosterone (16.6% means difference, P=<0.001), 11-hydroxytestosterone (16.6% means difference, P=<0.001), and 11-ketoandrostenedione (19.4% means difference, P=<0.001) than the non-users and gestagen users.

Conclusion: Lower levels of 11-oxygenated androgens in CHC users may have direct clinical impact for treatment of hyperandrogenic conditions like polycystic ovary syndrome, in which 11-oxygenated androgens are elevated.