Maas Kevin H, Chuan Sandy, Harrison Evan, Cook-Andersen Heidi, Duleba Antoni J, Chang R Jeffrey
Department of Reproductive Medicine, University of California, San Diego, La Jolla, California.
Department of Reproductive Medicine, University of California, San Diego, La Jolla, California.
Fertil Steril. 2016 Oct;106(5):1252-1257. doi: 10.1016/j.fertnstert.2016.06.039. Epub 2016 Jul 26.
To compare androgen responses during ACTH infusion among women with polycystic ovary syndrome (PCOS) and healthy women.
Cross-sectional study.
Academic medical center.
PATIENT(S): Women with PCOS (n = 13) and healthy controls (n = 15).
INTERVENTION(S): Blood samples were obtained frequently during a 6-hour dose-response ACTH infusion.
MAIN OUTCOME MEASURE(S): Comparison of basal and stimulated levels of 17α-hydroxyprogesterone (17-OHP), androgens, and cortisol (F) during ACTH infusion with those after hCG injection within individual subjects.
RESULT(S): In women with PCOS increased 17-OHP, androstenedione (A), and DHEA responses during ACTH infusion were comparable to those observed in healthy controls. The magnitude of responses was highly variable among women with PCOS. Within individual women with PCOS adrenal responses to ACTH and ovarian responses to hCG were significantly correlated. Cortisol responses to ACTH were similar in women with PCOS and healthy controls.
CONCLUSION(S): Within individual women with PCOS, enhanced androgen responses to ACTH are accompanied by comparable androgen responsiveness to hCG. These findings suggest that dysregulated steroidogenesis leading to hyperandrogenemia in this disorder is likely present in both adrenal and ovarian tissues.
NCT00747617.
比较多囊卵巢综合征(PCOS)女性与健康女性在促肾上腺皮质激素(ACTH)输注期间的雄激素反应。
横断面研究。
学术医疗中心。
PCOS女性(n = 13)和健康对照者(n = 15)。
在6小时的ACTH剂量反应输注过程中频繁采集血样。
比较个体受试者在ACTH输注期间以及注射人绒毛膜促性腺激素(hCG)后17α-羟孕酮(17-OHP)、雄激素和皮质醇(F)的基础水平和刺激水平。
PCOS女性在ACTH输注期间17-OHP、雄烯二酮(A)和脱氢表雄酮(DHEA)反应的增加与健康对照者中观察到的反应相当。PCOS女性中反应的幅度差异很大。在个体PCOS女性中,肾上腺对ACTH的反应与卵巢对hCG的反应显著相关。PCOS女性和健康对照者对ACTH的皮质醇反应相似。
在个体PCOS女性中,对ACTH增强的雄激素反应伴随着对hCG相当的雄激素反应性。这些发现表明,导致该疾病高雄激素血症的类固醇生成失调可能同时存在于肾上腺和卵巢组织中。
NCT00747617。