575
Chapter 58 Hyperandrogenism
Erica L. Borman, DO and
Stephen G. Somkuti, MD, PhD❍ What are the three sources of androgen production?
Ovary (25%), adrenal (25%), and periphery (50%).
❍ What is the first step in adrenal steroid synthesis?
The first step in adrenal steroid synthesis is the combination of acetyl CoA and squalene to form cholesterol, which
is then converted into pregnenolone.
❍ In what disease process or syndrome is androstenedione secreted primarily by the ovary compared to normal
premenopausal women who have equal production from the ovaries and the adrenals?
Polycystic ovary syndrome (PCOS).
❍ What is the most potent circulating androgen?
Testosterone.
❍ What are the effects of excess androgen in prepubertal boys?
- Penile enlargement, growth of hair in androgen-dependent areas, deepening of the voice, and development of
other secondary sexual characteristics. - Increases height velocity, somatic development, and skeletal maturation.
- Premature epiphyseal fusion leading to short adult height.
❍ What are the effects of excess androgen in prepubertal girls?
- Hirsutism, acne, and clitoromegaly (eg, heterosexual precocious puberty).
- Increases height velocity, somatic development, and skeletal maturation.
- Premature epiphyseal fusion leading to short adult height.
❍ What are the effects of excess androgen in pubertal boys?
Increases the rate of progression of puberty and skeletal maturation, and decreases adult height.