[Androgen response in women with polycystic ovary syndrome and hyperinsulinemia during stimulation with corticotrophin and inhibition with dexamethasone].
The adrenal response to adrenocorticotropic hormone (ACTH) stimulation and dexamethasone (DEX) inhibition tests in six healthy ovulatory control women (31.6 +/- SD 0.6 years old) with a body mass index (BMI) of 24.8 +/- 1.3 kg/m2 (Group 1) were compared against seven women (28.1 +/- 0.8 years old, BMI 30.9 +/- 2.1 kg/m2) with polycystic ovary syndrome (PCOS) and hyperinsulinism (Group 2). In both groups the following tests were performed: a) a 100-g 2-h oral glucose tolerance test (OGTT) with serum glucose and insulin measurements; b) an ACTH stimulation test (2-h 0.25 mg iv bolus); and c) a 1 mg oral midnight DEX inhibition test. Assays of serum cortisol. 17-hydroxyprogesterone, dehydroepiandrosterone sulfate (DHEA-S), free testosterone (FT), and androstenedione during the ACTH and DEX tests were performed. Contrary to Group 1, Group 2 showed: a) higher basal luteinizing hormone follicle-stimulating hormone ratio, FT, and insulin, and hyperinsulinism during the OGTT; b) FT significantly higher after ACTH; and c) FT and DHEAS did not show a significant inhibition with DEX. Our results suggest a certain degree of adrenal participation in the pathogenesis of the hyperandrogenism in these women, which may be the final expression of a synergistic stimulation of the adrenals by hyperinsulinism, relatively high LH, and chronic hyperestrogenism, all of which are present virtually in all women with PCOS.
Espinosa de los Monteros
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Departamento de Endocrinología, Instituto Nacional de Perinatología México, D.F.
Guerra de la Garza
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Barrón
J
J
Parra
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D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood; D003907:Dexamethasone; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006946:Hyperinsulinism / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D013739:Testosterone / Q000097:blood
D000728:Androgens; D005938:Glucocorticoids; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019326:17-alpha-Hydroxyprogesterone; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
Respuesta de andrógenos en mujeres con síndrome de ovarios poliquísticos e hiperinsulinemia durante la estimulación con córticotrofina e inhibición con dexametasona.