Buyalos R P, Bradley E L, Judd H L, Zacur H A, Azziz R
Department of Obstetrics and Gynecology, University of California, Los Angeles.
Fertil Steril. 1991 Dec;56(6):1179-82.
Conflicting information concerning the acute effect of hyperinsulinemia on circulating adrenal androgens, specifically DHEAS, is available. The effect of PCOD or obesity on this response is unclear. We prospectively examined the acute response of circulating DHEAS to the physiological rise in serum insulin after an OGTT in 10 women with PCOD (5 obese and 5 normal weight) and 10 ovulatory euandrogenic women (5 obese and 5 normal-weight). All underwent a standard 75-g 2-hour OGTT. Insulin and DHEAS were measured before and after OGTT. To control for the potential dilutional effects induced by hyperinsulinemia or hyperglycemia on intravascular tonicity, DHEAS levels were correlated to serum protein. As expected, the 2-hour insulin levels were significantly greater than baseline. No significant changes in circulating DHEAS or in the DHEAS to protein ratio was observed in any patient group 2 hours after glucose-induced hyperinsulinemia. The power of this study was greater than 89% for an alpha error of 0.05 and an expected change in DHEAS of 25%. In summary, it appears unlikely that acute increases in insulin within the physiological range are important in the regulation of circulating DHEAS in either PCOD or euandrogenic women, independent of obesity.
关于高胰岛素血症对循环肾上腺雄激素，特别是硫酸脱氢表雄酮（DHEAS）的急性影响，存在相互矛盾的信息。多囊卵巢综合征（PCOD）或肥胖对这种反应的影响尚不清楚。我们前瞻性地研究了10名PCOD女性（5名肥胖和5名正常体重）和10名排卵正常且雄激素水平正常的女性（5名肥胖和5名正常体重）在口服葡萄糖耐量试验（OGTT）后，循环DHEAS对血清胰岛素生理性升高的急性反应。所有人都接受了标准的75克2小时OGTT。在OGTT前后测量胰岛素和DHEAS。为了控制高胰岛素血症或高血糖对血管内张力引起的潜在稀释效应，将DHEAS水平与血清蛋白相关联。正如预期的那样，2小时胰岛素水平显著高于基线。在葡萄糖诱导的高胰岛素血症2小时后，任何患者组中循环DHEAS或DHEAS与蛋白比率均未观察到显著变化。对于0.05的α错误率和DHEAS预期变化25%，本研究的检验效能大于89%。总之，生理范围内胰岛素的急性增加似乎不太可能在PCOD或雄激素水平正常的女性中，独立于肥胖，对循环DHEAS的调节起重要作用。
