Reassessment of adrenal androgen secretion in women with polycystic ovary syndrome.
OBJECTIVE
To reevaluate the clinical significance of elevations of adrenal androgens in polycystic ovary syndrome (PCOS).


METHODS
Thirty women with PCOS and ten ovulatory controls were evaluated. Serum dehydroepiandrosterone (DHEA) sulfate and 11 beta-hydroxyandrostenedione were measured before and after 3 and 6 months of GnRH agonist (GnRH-A) therapy. All controls and 15 women with PCOS received intravenous ACTH before and after GnRH-A therapy.


RESULTS
Twenty-one (70%) of the women with PCOS had elevations of DHEA sulfate, and 16 (53%) had elevations in 11 beta-hydroxyandrostenedione. Only two women with PCOS had normal values of both adrenal androgens. After GnRH-A therapy, only 11 subjects (37%) had elevated values of DHEA sulfate. Four of 16 women had reductions in 11 beta-hydroxyandrostenedione. Only those with elevated baseline DHEA sulfate levels had reductions after GnRH-A therapy. The reduction of DHEA sulfate with GnRH-A correlated with the reduction in androstenedione. Of the subjects who had reductions in DHEA sulfate with GnRH-A therapy, there was a blunted response of DHEA to ACTH after treatment.


CONCLUSIONS
Our findings suggest that the ovary may influence the prevalence and magnitude of adrenal androgen excess in PCOS.
Carmina
E
E
Cattedra di Endocrinologia, Universita di Palermo, Italy.
Gonzalez
F
F
Chang
L
L
Lobo
R A
RA
D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D000328:Adult; D000735:Androstenedione / Q000031:analogs & derivatives* / Q000097:blood; D016022:Case-Control Studies; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives* / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D005260:Female; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000378:metabolism*; D017329:Triptorelin Pamoate / Q000627:therapeutic use
D017329:Triptorelin Pamoate; D000735:Androstenedione; D003687:Dehydroepiandrosterone; C003582:11-hydroxyandrostenedione; D019314:Dehydroepiandrosterone Sulfate; D000324:Adrenocorticotropic Hormone; D016729:Leuprolide