Kim S Y, Sung Y A, Ko K S, Cho B Y, Lee H K, Koh C S, Min H K
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
Korean J Intern Med. 1993 Jan;8(1):8-14. doi: 10.3904/kjim.1993.8.1.8.
Women with hyperprolactinemia have been reported to have hyperandrogenemia and/or insulin resistance. However, little is known about the association of hyperandrogenemia and insulin resistance in these women. To investigate whether hyperandrogenemia and/or insulin resistance occur in hyperprolactinemic women, and to assess the relationship between them, we measured basal androgen level and both glucose and insulin levels after oral glucose administration in 20 hyperprolactinemic women and 7 female control subjects. Free testosterone level was higher and estradiol level lower in hyperprolactinemic women than in control subjects (p < 0.05), whereas dehydroepiandrosterone sulfate (DHEAS) and total testosterone levels were similar (p > 0.05). Both fasting glucose and insulin levels didn't differ in the two groups (p > 0.05). However, both serum glucose and insulin levels, after a 75 g glucose load, were significantly increased in hyperprolactinemic women, (p = 0.001, p < 0.001, respectively). In simple linear regression analysis in hyperprolactinemic women, only free testosterone level had a positive correlation with the incremental area under the insulin curve (insulin-IAU) (r = 0.47, p < 0.05). In multiple stepwise regression analysis, free testosterone level, mean blood pressure and DHEAS level were associated significantly with insulin-IAU (beta = 0.98, p < 0.0001; beta = 0.58, p = 0.002; beta = -0.67, p < 0.003, respectively). These results suggest that insulin resistance is closely related to elevated free testosterone level in hyperprolactinemic women.
据报道，患有高泌乳素血症的女性存在高雄激素血症和/或胰岛素抵抗。然而，对于这些女性中高雄激素血症与胰岛素抵抗之间的关联却知之甚少。为了研究高泌乳素血症女性是否存在高雄激素血症和/或胰岛素抵抗，并评估它们之间的关系，我们测量了20名高泌乳素血症女性和7名女性对照受试者的基础雄激素水平以及口服葡萄糖后的血糖和胰岛素水平。高泌乳素血症女性的游离睾酮水平高于对照受试者，雌二醇水平低于对照受试者（p < 0.05），而硫酸脱氢表雄酮（DHEAS）和总睾酮水平相似（p > 0.05）。两组的空腹血糖和胰岛素水平均无差异（p > 0.05）。然而，在给予75g葡萄糖负荷后，高泌乳素血症女性的血清葡萄糖和胰岛素水平均显著升高（分别为p = 0.001，p < 0.001）。在高泌乳素血症女性的简单线性回归分析中，只有游离睾酮水平与胰岛素曲线下增量面积（胰岛素-IAU）呈正相关（r = 0.47，p < 0.05）。在多元逐步回归分析中，游离睾酮水平、平均血压和DHEAS水平与胰岛素-IAU显著相关（β = 0.98，p < 0.0001；β = 0.58，p = 0.002；β = -0.67，p < 0.003）。这些结果表明，胰岛素抵抗与高泌乳素血症女性游离睾酮水平升高密切相关。
