Ovarian influence on adrenal androgen secretion in polycystic ovary syndrome.
OBJECTIVE
To determine whether the ovary influences adrenal androgen secretion in polycystic ovary syndrome (PCOS).


METHODS
The adrenal androgen secretion was evaluated before and during ovarian suppression with a long-acting GnRH agonist.


METHODS
Department of Obstetrics and Gynecology, Pisa, Italy.


METHODS
Women with PCOS and high (10 subjects) and normal (12 subjects) DHEAS levels and 6 normal women.


METHODS
After 1 mg dexamethasone, an ACTH-(1-24) stimulation test was performed in the early follicular phase of the menstrual cycle. The test was repeated after two injections of a long-acting GnRH analogue (GnRH-a).


METHODS
Basal plasma levels of gonadotropins, E2, T, androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), DHEAS, and cortisol (F) were evaluated before the evening administration of dexamethasone. Serum A, T, 17-OHP, DHEAS, and F were measured 9 hours after dexamethasone and in samples collected 60 and 120 minutes after ACTH IV injection.


RESULTS
In the high DHEAS group the maximum increases in T, A, 17-OHP, and DHEAS in response to ACTH were significantly higher than in normal DHEAS PCOS women and in normal women. The GnRH-a modified the A and T responses to ACTH in the high DHEAS group.


CONCLUSIONS
Ovarian steroids, or other extra-ovarian factors, seem to be responsible for the increased A and T responses to the corticotropin stimulation demonstrated in some PCOS women.
Fruzzetti
F
F
Department of Obstetrics and Gynecology, University of Pisa, Italy.
De Lorenzo
D
D
Ricci
C
C
Teti
G
G
D000293:Adolescent; D000311:Adrenal Glands / Q000378:metabolism*; D000328:Adult; D000728:Androgens / Q000097:blood / Q000378:metabolism*; D003366:Cosyntropin / Q000494:pharmacology; D003907:Dexamethasone / Q000494:pharmacology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D010053:Ovary / Q000503:physiopathology*; D010446:Peptide Fragments / Q000494:pharmacology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*
D000728:Androgens; D010446:Peptide Fragments; D003366:Cosyntropin; D007987:Gonadotropin-Releasing Hormone; D003907:Dexamethasone