Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome.
OBJECTIVE
To test the hypothesis that increasing DHEAS levels is associated with improved insulin resistance in patients with polycystic ovary syndrome (PCOS).


METHODS
Cross-sectional cohort analysis.


METHODS
Academic medical center.


METHODS
Three hundred fifty-two women with PCOS.


METHODS
Patients presenting for evaluation of symptoms related to androgen excess were evaluated physically and biochemically through laboratory analysis.


METHODS
Circulating DHEAS, total T, free T, sex hormone-binding globulin (SHBG), and 17-hydroxyprogesterone (17-OHP) levels, and calculated homeostasis model assessment of insulin resistance (HOMA-IR).


RESULTS
Bivariate analysis indicated that all parameters were associated with HOMA-IR, except 17-OHP and age, and confirmed a negative correlation between DHEAS and HOMA-IR. Multivariate analysis indicated that increases in DHEAS, SHBG, 17-OHP, and age were associated with decreasing HOMA-IR, whereas increases in free T, body mass index (BMI), and waist-to-hip ratio (WHR) were associated with increasing HOMA-IR. In decreasing order of importance, the following variables predicted insulin resistance: BMI > WHR > age > DHEAS > free T > SHBG > 17-OHP.


CONCLUSIONS
DHEAS is negatively correlated to insulin resistance in patients with PCOS, and in our model ranked just behind other well-established predictors including BMI, WHR, and age. Whether this is due to a direct beneficial effect on insulin action by adrenal androgens such as DHEA, or whether DHEAS simply reflects the circulating levels of hyperinsulinemia, remains to be determined.
Brennan
Kathleen
K
Department of Obstetrics and Gynecology, the David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Huang
Andy
A
Azziz
Ricardo
R
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio
D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone