Androgen excess contributes to altered growth hormone/insulin-like growth factor-1 axis in nonobese women with polycystic ovary syndrome.
OBJECTIVE
To investigate the relationship between ovarian androgen excess and impaired growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis in nonobese women with polycystic ovary syndrome (PCOS).


METHODS
A prospective, controlled clinical study.


METHODS
Reproductive Endocrine Unit, Department of Obstetrics and Gynecology, Jinling Hospital, Nanjing University School of Clinical Medicine.


METHODS
Six patients with PCOS with both clomiphene resistance and gonadotropin hyperreponsiveness and six controls with regular cycles, matched for age and body mass index (BMI).


METHODS
Bilateral ovarian wedge resection (OWR) was performed to induce ovulation surgically for these refractory women with PCOS. A GH stimulation test with oral L-dopa was arranged for controls and for patients with PCOS before and again 6 months later after OWR.


METHODS
Plasma GH, IGF-1, FSH, LH, testosterone, androstenedione, estradiol, progesterone, prolactin, insulin, and glucose.


RESULTS
Basal levels and areas under the response curve of GH and GH-IGF-1 ratio to L-dopa were significantly lower in patients with PCOS before surgery than those of controls. The OWR in patients with PCOS obviously reduced their androstenedione and testosterone levels and insulin-glucose ratios, and increased the GH and GH-IGF-1 responses to L-dopa.


CONCLUSIONS
Impaired somatotrophic axis caused by a defect in central dopaminergic activity may be responsible for severe anovulation in these women with PCOS, which could be reversed by removing excessive androgens with OWR.
Wu
X
X
University Central Hospital of Turku, Turku, Finland. xiaoke.wu@utufi
Sallinen
K
K
Zhou
S
S
Su
Y
Y
Pöllänen
P
P
Erkkola
R
R
D000328:Adult; D000728:Androgens / Q000378:metabolism*; D000735:Androstenedione / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D019382:Human Growth Hormone / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D007334:Insulin-Like Growth Factor I / Q000187:drug effects / Q000378:metabolism*; D007980:Levodopa / Q000494:pharmacology; D007986:Luteinizing Hormone / Q000097:blood; D009765:Obesity / Q000378:metabolism; D010053:Ovary / Q000601:surgery; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood
D000728:Androgens; D019382:Human Growth Hormone; D013739:Testosterone; D000735:Androstenedione; D007980:Levodopa; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone