title: In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake.
abstract: OBJECTIVE
  To investigate adrenal steroid regulation in polycystic ovary syndrome.
  
  
  METHODS
  Five-hour oral glucose tolerance test (OGTT) and frequently sampled-intravenous gluclose tolerance test.
  
  
  METHODS
  University research center.
  
  
  METHODS
  Thirty patients.
  
  
  METHODS
  None.
  
  
  METHODS
  Anthropometrics, leptin, cortisol, DHEAS, glucose, insulin.
  
  
  RESULTS
  Morning cortisol correlated with sensitivity index (SI, r = .540), DHEAS correlated inversely with age (r = -.6359), body mass index (BMI, r = -.6199), fat mass (r = -0.630), and leptin (r = -0.5676). Between the second and fourth hour of OGTT, cortisol changes (Delta) exhibited three patterns: I, responders (n = 9, Delta: 10.7 +/- 1.0 microg/dL); II, nonresponders (n = 10, Delta: -3.5 +/- 0.6 microg/dL); III, intermediates (n = 11, Delta: 4.3 +/- 1.0 microg/dL). Compared with nonresponders, responders were more obese (BMI: 37.0 +/- 1.6 vs. 31.7 +/- 1.8 kg/m(2)); had higher leptin (28.9 +/- 1.7 vs. 24.1 +/- 1.1 ng/mL), and lower DHEAS (133 +/- 12 vs. 236 +/- 32 ng/mL), higher glucose at 1 h of OGTT (195 +/- 13 vs. 131 +/- 12 mg/dL), higher area under the curve (AUC)(Glucose) (332 +/- 20 vs. 265 +/- 17 mg/dL), higher AUC(Insulin) (244 +/- 50 vs. 125 +/- 30 muU/mL), and lower nadir glucose (61 +/- 2 vs. 70 +/- 2 mg/dL).
  
  
  CONCLUSIONS
  Obesity and insulin resistance are associated with lower morning cortisol and DHEAS but increased cortisol and DHEA responses after glucose ingestion. Morning steroid levels may not reflect the day-long exposure.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Clinical Nutrition and Vascular Medicine, The University of California at Davis, Davis, California, USA.
authors.forename: Dumindra
authors.initials: D
authors.lastname: Gurusinghe
authors.forename: Sharan
authors.initials: S
authors.lastname: Gill
authors.forename: Rogelio U
authors.initials: RU
authors.lastname: Almario
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lee
authors.forename: William F
authors.initials: WF
authors.lastname: Horn
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keim
authors.forename: Kyoungmi
authors.initials: K
authors.lastname: Kim
authors.forename: Sidika E
authors.initials: SE
authors.lastname: Karakas