title: Adrenal steroidogenesis is related to insulin in hyperandrogenic women.
abstract: OBJECTIVE
  To evaluate ovarian and adrenal steroid secretion in women with severe hyperandrogenism.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  The Gynecological Endocrine Research Unit of the University Central Hospital, Oulu, Finland.
  
  
  METHODS
  Thirteen obese, hirsute women with severe hyperandrogenism.
  
  
  METHODS
  Adrenocorticotropin hormone stimulation and dexamethasone suppression tests and selective catheterizations of the left ovarian and adrenal veins were performed.
  
  
  METHODS
  The concentrations of insulin, P, 17-hydroxyprogesterone (17-OHP), androstenedione (A), T, DHEA, DHEAS, and cortisol were measured.
  
  
  RESULTS
  The secretory gradients of T and its precursors, P, 17-OHP, A, and DHEA in the selective catheterizations showed the adrenal to be the main source of excessive steroid production in these patients. The concentrations of P (r = 0.82), 17-OHP (r = 0.89), A (r = 0.84), T (r = 0.86), and cortisol (r = 0.87) in the adrenal vein showed a strong correlation with insulin measured from the same samples.
  
  
  CONCLUSIONS
  Excessive androgens were secreted mainly by the adrenals in these obese hyperinsulinemic women. Correlation analyses suggested that insulin stimulates adrenal androgen and cortisol secretion, which may constitute an important component of the pathogenetic mechanisms of hyperandrogenism and the polycystic ovary syndrome.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital of Oulu, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Martikainen
authors.forename: P
authors.initials: P
authors.lastname: Salmela
authors.forename: S
authors.initials: S
authors.lastname: Nuojua-Huttunen
authors.forename: J
authors.initials: J
authors.lastname: Perälä
authors.forename: S
authors.initials: S
authors.lastname: Leinonen
authors.forename: M
authors.initials: M
authors.lastname: Knip
authors.forename: A
authors.initials: A
authors.lastname: Ruokonen
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000378:metabolism*; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D000328:Adult; D000728:Androgens / Q000096:biosynthesis*; D003907:Dexamethasone / Q000494:pharmacology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis*; D017588:Hyperandrogenism / Q000378:metabolism*; D007328:Insulin / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000728:Androgens; D007328:Insulin; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone