title: Ovarian steroids modulate neuroendocrine dysfunction in polycystic ovary syndrome.
abstract: OBJECTIVE
  Neuroendocrine dysfunction in polycystic ovary syndrome (PCOS) was addressed by studying the steroid hormone changes in women with PCOS with either high or normal LH levels leading to inferences regarding the primacy of elevated LH in the pathophysiology of PCOS.
  
  
  METHODS
  A cross-sectional study was designed in an academic clinical facility involving 234 women with PCOS. Patients were divided into two groups based on an LH/FSH ratio < or >1 and hormonal and metabolic studies were performed in both groups. Factors were determined by binomial logistic regression that predicted group membership of these women.
  
  
  RESULTS
  Higher follicular phase estradiol (E2) and androstenedione (A4) levels as well as greater insulin sensitivity were the only factors that predicted the presence of neuroendocrine dysfunction with elevated A4 being necessary for neuroendocrine dysfunction.
  
  
  CONCLUSIONS
  It was concluded that uncoupling of hypothalamic E2 inhibition by elevated ovarian A4 associated with E2 related sensitization of pituitary LH leads to neuroendocrine dysfunction in PCOS.
authors.affiliation: Division of Endocrinology, Mubarak Al-Kabeer Hospital and Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait. sardoi@gmx.net
authors.forename: S A R
authors.initials: SA
authors.lastname: Doi
authors.forename: M
authors.initials: M
authors.lastname: Al-Zaid
authors.forename: P A
authors.initials: PA
authors.lastname: Towers
authors.forename: C J
authors.initials: CJ
authors.lastname: Scott
authors.forename: K A S
authors.initials: KA
authors.lastname: Al-Shoumer
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D000328:Adult; D000735:Androstenedione / Q000097:blood* / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood* / Q000502:physiology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D009490:Neurosecretory Systems / Q000503:physiopathology*; D009765:Obesity / Q000503:physiopathology; D010902:Pituitary Gland / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000503:physiopathology*; D012044:Regression Analysis; D013739:Testosterone / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone