ACTH stimulation test in lean polycystic ovary syndrome patients with insulin resistance.
OBJECTIVE
To determine whether insulin resistance in nonobese polycystic ovarian syndrome (PCOS) patients is associated with a higher response to ACTH stimulation.


METHODS
Controlled prospective study.


METHODS
University hospital ambulatory care unit.


METHODS
Twenty nonobese PCOS syndrome patients with insulin resistance and a body mass index-matched control group of 20 nonobese PCOS patients without insulin resistance.


METHODS
A 75-g oral glucose tolerance test and an ACTH stimulation test.


METHODS
Blood insulin and glucose levels after ingestion of 75 g oral glucose; blood androstenedione (A), 17(OH)-progesterone [17(OH)-P], free and total T, DHEAS, and progesterone (P) response to ACTH stimulation.


RESULTS
The proportional increases in the blood levels of total and free T, DHEAS, A, 17(OH)-P, and P following ACTH stimulation were similar in the two groups. Only the insulin area under the curve (AUC) values were significantly different among the two groups. The insulin AUC values were positively correlated to the free T blood levels and the homeostasis model assessment scores.


CONCLUSIONS
Within the population of nonobese PCOS patients, insulin resistance is not associated with a more pronounced response to ACTH stimulation. The pathogenesis and management of PCOS in nonobese patients may be different from in obese patients.
Uncu
Gurkan
G
Department of Obstetrics and Gynecology, Medical Faculty, Uludag University, Gorukle-Bursa, Turkey. eozyurek@yahoo.com <eozyurek@yahoo.com>
Ozyurek
S Eser
SE
Uncu
Yesim
Y
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005163:Factor Analysis, Statistical; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone; D011374:Progesterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone