RESUMEN
OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Asunto(s)
Femenino , Humanos , Androstenodiona , Disponibilidad Biológica , Proteínas Portadoras , Estradiol , Hormona Folículo Estimulante , Hiperandrogenismo , Proteína 1 de Unión a Factor de Crecimiento Similar a la Insulina , Proteína 3 de Unión a Factor de Crecimiento Similar a la Insulina , Factor I del Crecimiento Similar a la Insulina , Factor II del Crecimiento Similar a la Insulina , Hormona Luteinizante , Ovario , Ovulación , Prolactina , Somatomedinas , Testosterona , Tirotropina , VoluntariosRESUMEN
Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(ADD), dehydroepiandrosterone-sulfate(DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and E2 in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thermal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH follicular development and dominant follicle selection resulted in ovulatory disturbance.
Asunto(s)
Femenino , Humanos , Diagnóstico , Estrógenos , Atresia Folicular , Hormona Liberadora de Gonadotropina , Gonadotropinas , Células de la Granulosa , Hipertrofia , Inhibinas , Luteína , Ciclo Menstrual , Ovario , Péptidos , Prolactina , Estudios Prospectivos , Receptores de HL , UltrasonografíaRESUMEN
Women with Polycystic ovaries(PCO) are often overweight and obesity has been regarded as a possible basis for the development of PCO. This study was designed to evaluate the differences of the basic hormonal concentrations and sonographic features in obese and non-obese patients with PCO. We prospectively analysed eighty-six patiens with PCO on transvaginal sonography and twelve control women with regular menstrual cycle and ovarian morphology from Feb. 1994 to May 1996. Eighty-six women with PCO, of whom sixty-seven women were non -obese with body mass index(BMI) of 25(=group 2). Sonographic morphology of ovary was evaluated in PCO. Basal concent- rations of LH, FSH, estrone, estradiol, testosterone(T), prolactin, TSH and sex hormone- binding globulin(SHBG) in serum were measured. Although sonographic morphology of ovary was not significantly different between group 1 and group 2, number of small follicles was tend to increase in group 2. The LH/ FSH ratio was significantly higher in group 1 compared to group 2, but SHBG was higher in group 2. Conclusively, in obese women, obesity causes an increase in free androgen through the decrease in SHBG, which might cause a disturbance in gonadotropin secretion leading to the typical changes of polycystic ovary. In non-obese women, relative increase of LH/FSH ratio stimulates excessive production of androgen.