In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake

Dumindra Gurusinghe, Sharan Gill, Rogelio U. Almario, Jennifer Lee, William F. Horn, Nancy L. Keim, Kyoungmi Kim, Siddika E Karakas

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: To investigate adrenal steroid regulation in polycystic ovary syndrome. Design: Five-hour oral glucose tolerance test (OGTT) and frequently sampled-intravenous gluclose tolerance test. Setting: University research center. Patient(s): Thirty patients. Intervention(s): None. Main Outcome Measure(s): Anthropometrics, leptin, cortisol, DHEAS, glucose, insulin. Result(s): Morning cortisol correlated with sensitivity index (SI, r = .540), DHEAS correlated inversely with age (r = -.6359), body mass index (BMI, r = -.6199), fat mass (r = -0.630), and leptin (r = -0.5676). Between the second and fourth hour of OGTT, cortisol changes (Δ) exhibited three patterns: I, responders (n = 9, Δ: 10.7 ± 1.0 μg/dL); II, nonresponders (n = 10, Δ: -3.5 ± 0.6 μg/dL); III, intermediates (n = 11, Δ: 4.3 ± 1.0 μg/dL). Compared with nonresponders, responders were more obese (BMI: 37.0 ± 1.6 vs. 31.7 ± 1.8 kg/m2); had higher leptin (28.9 ± 1.7 vs. 24.1 ± 1.1 ng/mL), and lower DHEAS (133 ± 12 vs. 236 ± 32 ng/mL), higher glucose at 1 h of OGTT (195 ± 13 vs. 131 ± 12 mg/dL), higher area under the curve (AUC)Glucose (332 ± 20 vs. 265 ± 17 mg/dL), higher AUCInsulin (244 ± 50 vs. 125 ± 30 μU/mL), and lower nadir glucose (61 ± 2 vs. 70 ± 2 mg/dL). Conclusion(s): Obesity and insulin resistance are associated with lower morning cortisol and DHEAS but increased cortisol and DHEA responses after glucose ingestion. Morning steroid levels may not reflect the day-long exposure.

Original languageEnglish (US)
Pages (from-to)1192-1199
Number of pages8
JournalFertility and Sterility
Volume93
Issue number4
DOIs
StatePublished - Mar 1 2010

Keywords

  • Adrenal steroids
  • insulin resistance
  • leptin
  • obesity
  • PCOS

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

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