THE ROLE OF ADRENAL HYPERANDROGENISM, INSULIN RESISTANCE, AND OBESITY IN THE PATHOGENESIS OF POLYCYSTIC OVARIAN SYNDROME

被引:69
|
作者
RITTMASTER, RS [1 ]
DESHWAL, N [1 ]
LEHMAN, L [1 ]
机构
[1] DALHOUSIE UNIV, DEPT MED, HALIFAX B3J 1B6, NS, CANADA
来源
关键词
D O I
10.1210/jc.76.5.1295
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hyperandrogenism, insulin resistance, and obesity are common features of polycystic ovarian syndrome (PCOS). This study was designed to investigate the relationship among these factors and how they might contribute to ovulatory dysfunction in PCOS. Adrenal androgen secretion and insulin resistance were quantified in oligomenorrheic women with PCOS and in three groups of eumenorrheic women: weight-matched hirsute women, obese nonhirsute women, and thin nonhirsute women. Adrenal androgen secretion was defined as the androstenedione response to synthetic corticotropin. Insulin resistance was estimated by calculating the area under the curve for serum insulin levels in response to a 75 g oral glucose load. The mean serum androstenedione response (nmol/L) to corticotropin in PCOS (5.6 +/- 1.3) was greater than that in eumenorrheic hirsute women (3.4 +/- 0.5; P < 0.10), obese nonhirsute women (1.8 +/- 0.8; P < 0.05), and lean nonhirsute women (1.9 +/- 0.5; P < 0.05). The serum androstenedione response was not correlated with body mass index (BMI). The area under the curve for serum insulin (mU/L . min/1000) in PCOS (29.1 +/- 5.3) was greater (P < 0.001) than in eumenorrheic hirsute women (9.1 +/- 1.7), obese nonhirsute women (5.8 +/- 1.0), and lean nonhirsute women (4.5 +/- 0.4). The serum insulin response was highly correlated with BMI (P < 0.001) in the three groups of obese women, but women with PCOS became significantly more insulin resistant with increasing BMI (P < 0.02). There was no correlation between adrenal androgen secretion and insulin resistance in any of the groups. We conclude that adrenal hyperandrogenism and insulin resistance are independent predictors of anovulation in hirsute women. These conditions are present in both oligomenorrheic and eumenorrheic hirsute women, but are present to a greater extent in anovulatory women. Obese women with PCOS also differ from eumenorrheic controls by developing a greater degree of insulin resistance as body mass increases.
引用
收藏
页码:1295 / 1300
页数:6
相关论文
共 50 条
  • [1] Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity
    Zeng, Xin
    Xie, Yuan-jie
    Liu, Ya-ting
    Long, Shuang-lian
    Mo, Zhong-cheng
    [J]. CLINICA CHIMICA ACTA, 2020, 502 : 214 - 221
  • [2] Polycystic ovarian syndrome: signs and feedback effects of hyperandrogenism and insulin resistance
    Hernandez-Jimenez, Jenifer Lizbet
    Barrera, David
    Espinoza-Simon, Emilio
    Gonzalez, James
    Ortiz-Hernandez, Rosario
    Escobar, Luisa
    Echeverria, Olga
    Torres-Ramirez, Nayeli
    [J]. GYNECOLOGICAL ENDOCRINOLOGY, 2022, 38 (01) : 2 - 9
  • [3] Polycystic ovary syndrome, hyperandrogenism, and insulin resistance
    Zacur, HA
    [J]. OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA, 2001, 28 (01) : 21 - +
  • [4] Insulin Resistance Is a Sufficient Basis for Hyperandrogenism in Lipodystrophic Women with Polycystic Ovarian Syndrome
    Lungu, Andreea O.
    Zadeh, Elika Safar
    Goodling, Anne
    Cochran, Elaine
    Gorden, Phillip
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2012, 97 (02): : 563 - 567
  • [5] The impact of adrenal hyperandrogenism on insulin resistance and lipid profile in women with polycystic ovary syndrome
    Paschou, S. A.
    Loannidis, D.
    Mizamtsidi, M.
    Panagiotakou, A.
    Grammatikou, S.
    Karageorgos, G.
    Vryonidou, A.
    [J]. DIABETOLOGIA, 2016, 59 : S231 - S231
  • [6] The Roles of Inappropriate Gonadotropin Secretion and Insulin Resistance in the Pathogenesis of Hyperandrogenism in Polycystic Ovary Syndrome
    Dong Xuejie
    Liu Jia
    Hu Yanjin
    Xu Yuan
    Wang Guang
    [J]. DIABETES, 2016, 65 : A592 - A593
  • [7] Obesity and insulin resistance but not hyperandrogenism mediates vascular dysfunction in women with polycystic ovary syndrome
    Dokras, Anuja
    Jagasia, Dinesh H.
    Maifeld, Michelle
    Sinkey, Christine A.
    VanVoorhis, Bradley J.
    Haynes, William G.
    [J]. FERTILITY AND STERILITY, 2006, 86 (06) : 1702 - 1709
  • [8] DOES ETHNICITY INFLUENCE THE PREVALENCE OF ADRENAL HYPERANDROGENISM AND INSULIN RESISTANCE IN POLYCYSTIC-OVARY-SYNDROME
    CARMINA, E
    KOYAMA, T
    CHANG, L
    STANCZYK, FZ
    LOBO, RA
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1992, 167 (06) : 1807 - 1812
  • [9] Adrenal Hyperandrogenism and Polycystic Ovary Syndrome
    Luque-Ramirez, Manuel
    Escobar-Morreale, Hector F.
    [J]. CURRENT PHARMACEUTICAL DESIGN, 2016, 22 (36) : 5588 - 5602