title: Impact of glycemic variations on the regulation of androgen metabolism in obese women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To assess the influence of alterations in glucose concentrations on androgen levels in patients with polycystic ovary syndrome (PCOS) and in healthy controls.
  
  
  METHODS
  Prospective, controlled study.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Seven patients with PCOS and 20 healthy controls.
  
  
  METHODS
  Hyperinsulinemic glucose clamp study with stepwise reduction of the plasma glucose level from hyperglycemia to hypoglycemia.
  
  
  METHODS
  Concentrations of insulin, C-peptide, cortisol, T, androstenedione, 17-hydroxyprogesterone, DHEA, and DHEAS during hyperglycemia, euglycemia, and hypoglycemia.
  
  
  RESULTS
  Total T levels and the free androgen index were significantly higher in the PCOS group at baseline and throughout the clamp. The levels of T, androstenedione, DHEAS, and 17-hydroxyprogesterone were not influenced by short-term changes of plasma glucose concentrations in both groups. However, hypoglycemia led to a significant increase in DHEA levels in PCOS patients as well as in controls. Cortisol levels were not increased during hypoglycemia in either group.
  
  
  CONCLUSIONS
  In contrast to men, androgen levels are not influenced by short-term changes of plasma glucose levels in PCOS patients and in healthy women. However, DHEA concentrations increase with decreasing glucose levels independently from an activation of the hypothalamic-pituitary-adrenal axis. This supports a gender difference regarding the counterregulatory hormone response to hypoglycemia.
authors.affiliation: Center for Hormonal and Metabolic Disease, Reproductive Medicine, Gynecologic Endocrinology, and Prenatal Medicine, Endokrinologikum Hamburg, Lornsenstrasse 4-6, Hamburg, Germany. A.K.Ludwig@web.de
authors.forename: Annika K
authors.initials: AK
authors.lastname: Ludwig
authors.forename: Lilian G
authors.initials: LG
authors.lastname: Goharian
authors.forename: Theresa
authors.initials: T
authors.lastname: Dietze
authors.forename: Sacha
authors.initials: S
authors.lastname: Tauchert
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rudolf
authors.forename: Klaus
authors.initials: K
authors.lastname: Diedrich
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schweiger
authors.forename: Kerstin M
authors.initials: KM
authors.lastname: Oltmanns
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D009765:Obesity / Q000097:blood* / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D011446:Prospective Studies; D012016:Reference Values; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio; D055815:Young Adult
chemical_list: D000728:Androgens; D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone