Adrenal steroidogenesis is related to insulin in hyperandrogenic women.
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.
Martikainen
H
H
Department of Obstetrics and Gynecology, University Central Hospital of Oulu, Finland.
Salmela
P
P
Nuojua-Huttunen
S
S
Perälä
J
J
Leinonen
S
S
Knip
M
M
Ruokonen
A
A
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
D000728:Androgens; D007328:Insulin; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone