Impact of overnight dexamethasone suppression on the adrenal androgen response to an oral glucose tolerance test in women with and without polycystic ovary syndrome |
| |
Authors: | Buyalos RP; Geffner ME; Azziz R; Judd HL |
| |
Institution: | Department of Obstetrics and Gynecology, The University of California at Los Angeles, USA. |
| |
Abstract: | In order to test the hypothesis that adrenocortical overactivity, possibly
related to the stress of testing, may impact on the measurement of
circulating androgen concentrations during glucose- induced
hyperinsulinaemia, we prospectively screened 10 patients with the
polycystic ovary syndrome (PCOS) and nine healthy control women with an
oral glucose tolerance test (OGTT), before and after the administration of
dexamethasone. Blood sampling was performed at 0, 30, 60, 90, and 120 min
following the oral ingestion of 75 g of glucose, before and after the
administration of 1.0 mg dexamethasone on the evening prior to testing.
Total and free testosterone, androstenedione, dehydroepiandrosterone
(DHEA), DHEA sulphate (DHEAS), cortisol, glucose and insulin were assessed
during the 2 h OGTT. Women with PCOS had increased basal concentrations of
free testosterone, total testosterone, androstenedione, and insulin
compared to control women. In women with PCOS an acute decline in
circulating concentrations of DHEAS occurred during the OGTT. In PCOS women
there were no changes in other ovarian or adrenal androgens during OGTT
before or following dexamethasone administration. In control women DHEA
concentrations declined during the OGTT. Following overnight dexamethasone
suppression in control women, circulating concentrations of DHEAS and
testosterone also declined. It is concluded that: (i) in PCOS women only
the concentration of circulating DHEAS decreased during glucose-induced
hyperinsulinaemia and dexamethasone administration did not further alter
androgen responses to an OGTT; (ii) it is possible that, in these
hyperandrogenic patients, the insulin-related suppression of adrenocortical
testosterone and DHEA is negated by their much greater ovarian secretion of
these androgens; (iii) in control women DHEA concentrations acutely
declined during the OGTT and the administration of dexamethasone resulted
in the acute decline of DHEA, DHEAS, and testosterone; (iv) it appears that
the stress related to testing impacts on the androgen response to OGTT, at
least in healthy women.
|
| |
Keywords: | |
本文献已被 Oxford 等数据库收录! |
|