Abnormalities in the serum insulin-like growth factor-1 axis in women with hyperandrogenism.
OBJECTIVE
To study the insulin-like growth factor-1 (IGF-1) axis in hirsute women.


METHODS
Controlled clinical study.


METHODS
Tertiary care institutional hospital.


METHODS
Forty hirsute women and 17 women with normal menstrual cycles.


METHODS
Basal and ACTH-stimulated samples were obtained, and sampling was repeated 1 (gonadal stimulation) and 21 (gonadal suppression) days after a single 3.75-mg IM dose of triptorelin. Controls did not receive triptorelin for ethical reasons.


METHODS
Serum GH, IGF-1, IGF-binding protein-3 (IGFBP-3), insulin, glucose, total testosterone, sex hormone-binding globulin, E2, and gonadotropin levels. Basal and ACTH-stimulated steroid precursors were measured.


RESULTS
Patients with idiopathic hirsutism were identified by normal serum androgen levels (n=17). Those with functional ovarian hyperandrogenism (n=15) were identified by an increase in the serum testosterone level that normalized during gonadal suppression, whereas those with functional adrenal hyperandrogenism (n=8) were identified by an initial increase in the testosterone level that persisted during gonadal suppression. The adrenal hyperandrogenism group had increased IGF-1 levels compared with the control, idiopathic hirsutism, and ovarian hyperandrogenism groups. Patients with ovarian hyperandrogenism had normal TGF-1 concentrations, but their IGFBP-3 concentrations were lower than those of controls. No differences were observed in GH levels between any of the groups. These results persisted when the influence of age was corrected for.


CONCLUSIONS
The IGF-1 axis appears to be involved in the pathogenesis of hyperandrogenism, especially in patients with adrenal hyperandrogenism, who have a clear increase in IGF-1 levels. Moreover, patients with ovarian hirsutism have decreased IGFBP-3 concentrations, which might enhance IGF-1 bioavailability.
Escobar-Morreale
H F
HF
Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain. hector.escobar@uam.es
Serrano-Gotarredona
J
J
García-Robles
R
R
Varela
C
C
Sancho
J M
JM
D000305:Adrenal Cortex Hormones / Q000378:metabolism; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006628:Hirsutism / Q000097:blood*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood*; D007328:Insulin / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007527:Isoenzymes / Q000097:blood*; D010053:Ovary / Q000378:metabolism; D013254:Steroid 17-alpha-Hydroxylase / Q000097:blood*; D017329:Triptorelin Pamoate
D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D007527:Isoenzymes; D017329:Triptorelin Pamoate; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D000324:Adrenocorticotropic Hormone; D013254:Steroid 17-alpha-Hydroxylase