Ovarian influence on adrenal androgen secretion in polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 63; no. 4; pp. 734 - 741
• Main Authors: Fruzzetti, Franca, De Lorenzo, Daniele, Ricci, Cabiria, Teti, Giancarlo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1995; Elsevier Science
• Subjects: Adolescent; adrenal gland; Adrenal Glands - metabolism; Adult; androgens; Androgens - blood; Androgens - metabolism; Biological and medical sciences; Cosyntropin - pharmacology; Dexamethasone - pharmacology; Female; Female genital diseases; Gonadotropin-Releasing Hormone - agonists; Gynecology. Andrology. Obstetrics; Humans; Hyperandrogenism - blood; Hyperandrogenism - etiology; Hyperandrogenism - physiopathology; Medical sciences; Ovary - physiopathology; Peptide Fragments - pharmacology; Polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - metabolism; Polycystic Ovary Syndrome - physiopathology; Tumors; androgens; Polycystic ovary syndrome; adrenal gland; Endocrinopathy; Human; Androgen; Adrenal glands; Estrogen; 17β-Estradiol; Female sterility; Cortisol; Gonadotropin; Polycystic ovary; Glucocorticoid; Ovarian hormone; Female genital diseases; Ovarian diseases; Testosterone; Adrenal hormone; Cyst; Hyperandrogenism; Testicular hormone; Benign neoplasm; Hormonal investigation; Sex steroid hormone; Androstenedione; Hydroxyprogesterone
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(16)57474-3

To determine whether the ovary influences adrenal androgen secretion in polycystic ovary syndrome (PCOS). The adrenal androgen secretion was evaluated before and during ovarian suppression with a long-acting GnRH agonist. Department of Obstetrics and Gynecology, Pisa, Italy. Women with PCOS and high (10 subjects) and normal (12 subjects) DHEAS levels and 6 normal women. After 1 mg dexamethasone, an ACTH-(1-24) stimulation test was performed in the early follicular phase of the menstrual cycle. The test was repeated after two injections of a long-acting GnRH analogue (GnRH-a). Basal plasma levels of gonadotropins, E2, T, androstenedione (A), 17α-hydroxyprogesterone (17-OHP), DHEAS, and Cortisol (F) were evaluated before the evening administration of dexamethasone. Serum A, T, 17-OHP, DHEAS, and F were measured 9 hours after dexamethasone and in samples collected 60 and 120 minutes after ACTH IV injection. In the high DHEAS group the maximum increases in T, A, 17-OHP, and DHEAS in response to ACTH were significantly higher than in normal DHEAS PCOS women and in normal women. The GnRH-a modified the A and T responses to ACTH in the high DHEAS group. Ovarian steroids, or other extra-ovarian factors, seem to be responsible for the increased A and T responses to the corticotropin stimulation demonstrated in some PCOS women.