Assessment of insulin resistance in the idiopathic hirsutism.
BACKGROUND
Idiopathic hirsutism (IH) is the second most common cause of hirsutism, after polycystic ovary syndrome and occurs in about 15% of hirsute women. There are not many studies showing whether patients with IH also have insulin resistance. In the present study, we aimed to investigate the insulin sensivity in IH with non-obese and changing hormone levels during the hyperinsulinemic-euglycemic clamp.


METHODS
Twenty (20) non-obese women with IH (Group I) ranging in age from 20 to 30 (mean 25 +/- 5) years were studied. Hirsutism in women with normal testosterone (T) levels and regular menstrual cycles is as defined IH. Twenty (20) healthy women (mean age 23 +/- 2 years) (Group II) were included in this study as the control group. Insulin sensitivity was assessed with modified euglycemic insulin clamp technique. Samples of prolactin, luteinizing hormone (LH), follicle-stimulating hormone, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulfate, cortisol, estradiol, progesterone, 17-OH progesterone (17-OHP), total T, and free T (FT) were obtained at baseline and at 2nd hour during clamp.


RESULTS
Steady-state (120 min) glucose disposal rates were higher in Group II than Group I (7.51 +/- 0.83 vs. 5.76 +/- 1.89 mg/kg/min). Mean FT, ACTH, cortisol, LH, prolactin and 17-OHP levels were found to have decreased statistically significantly (p < 0.05) in Group I. Mean FT, ACTH, and prolactin levels were found to have decreased statistically significantly (p < 0.05) in Group II during the clamp. Mean baseline levels of FT, LH and prolactin were greater in women with hirsutism than in the control subjects (p < 0.05). Insulin mediated glucose disposal was lower in the normal weight women with IH than in those without hirsutism.


CONCLUSIONS
Mean FT, 17-OHP and dehydroepiandrosterone sulfate levels decreased during euglcemic-hyperinsulinemic clamp in IH.
Sarac
Fulden
F
Ege University Hospital, Department of Endocrinology and Metabolism, Bornova, Izmir, Turkey. fuldensarac@yahoo.com
Saygili
Fusun
F
Ozgen
Gökhan
G
Tuzun
Mehmet
M
Yilmaz
Candeger
C
Kabalak
Taylan
T
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000305:Adrenal Cortex Hormones / Q000097:blood; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004967:Estrogens / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005947:Glucose / Q000493:pharmacokinetics*; D015309:Glucose Clamp Technique; D006628:Hirsutism / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D013739:Testosterone / Q000097:blood; D013963:Thyroid Hormones / Q000097:blood
D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D004967:Estrogens; D007328:Insulin; D013963:Thyroid Hormones; D013739:Testosterone; D011374:Progesterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D005947:Glucose