Insulin resistance and adrenal androgen excess in adolescents with polycystic ovary syndrome / 中国糖尿病杂志

ABSTRACT

Objective To understand the correlation between insulin resistance(IR) and adrenal androgen excess in adolescents with polycystic ovary syndrome (PCOS). Methods According to BMI, 90 adolescents with PCOS were divided to groups of normal weight PCOS(NW-PCOS,33 cases,BMI<25.0 kg/m2) and obesity PCOS(OB-PCOS,57 cases, BMI≥ 25.0 kg/m2),and 15 normal weight healthy girls matched for age as controls.All patients had normal OGTT.Acute ACTH stimulating test was performed on patients, and cortisol (F), 17-hydroxyprogesterone(17-OHP), dehydroepiandrosterone(DHEA) during ACTH testing at 0 and 60 minute (steroid0 and steroid60) were determined. Results Compared with controls, NW-and OB-PCOS patients showed significantly greater levels of total testosterone (T), Luteotropic hormone(LH), FIns, 2 hIns, and HOMA-IR(P<0.01).The freqnencies of hirsuties and acne, and serum level of FIns, 2 hIns, and HOMA-IR were significantly higher and LH levels were much lower in the group of OB-PCOS than those in NW-PCOS(P<0.05 and P<0.01).ACTH stimulating test showed that PCOS patients had significantly higher levels of basal 17-OHP0, DHEA0, as well as 60-minute ACTH-stimulated levels (Steroid60) of 17-OHP60、DHEA60, and net increase of 17-OHP(Δ17-OHP)as compared with normal controls(P<0.05 and P<0.01).The 60-minute ACTH-stimulated levels of 17-OHP60, DHEA60,Δ17-OHP, and ΔDHEA were also higher in group of OB-PCOS than those in group of NW-PCOS(P<0.05 and P<0.01), and there were no obvious discrepancies in basal 17-OHP0, DHEA0 between OB-PCOS and NW-PCOS groups.Spearman correlation analysis showed that in group of OB-PCOS, HOMA-IR value was significantly associated with BMI, 17-OHP60, Δ17-OHP, DHEA60, ΔDHEA(P<0.05 and P<0.01); whereas in group of NW-PCOS, HOMA-IR was associated only with BMI(P<0.01). Conclusions The significantly higher basal and ACTH-stimulated levels of 17-OHP and DHEA indicates adrenal hyperresponsiveness in adolescents with PCOS.Adrenal androgen excess appears to be closely associated with insulin resistance in obese adolescents with PCOS