Anttila L, Koskinen P, Jaatinen T A, Erkkola R, Irjala K, Ruutiainen K
Department of Obstetrics and Gynaecology, Turku University Central Hospital, Finland.
Hum Reprod. 1993 Aug;8(8):1179-83. doi: 10.1093/oxfordjournals.humrep.a138224.
Female hyperandrogenism is often associated with hyperinsulinaemia and insulin resistance. We evaluated the hormone responses in an oral glucose tolerance test to investigate the interactions of gonadotrophins, insulin, C-peptide and androgens in women with polycystic ovarian disease (PCOD). In 28 patients with ultrasonographically diagnosed PCOD, hyperinsulinaemia and insulin resistance were mainly associated with obesity. Both basal and cumulative sum of insulin to C-peptide ratios were high in obese subjects, suggesting decreasing hepatic removal of insulin caused by obesity. Nevertheless, in some lean PCOD women, despite normal fasting insulin concentrations, insulin hypersecretion existed. The mean concentration of testosterone decreased significantly during the oral glucose tolerance test both in PCOD and control women, and of androstenedione in the PCOD patients only. However, an increase in androgen responses was found in a subgroup of PCOD patients, who had both elevated luteinizing hormone (LH) concentrations and hyperinsulinaemic response to oral glucose. In the remaining PCOD patients an inverse correlation between LH and insulin was found. The patients with hyperinsulinaemia together with LH hypersecretion may represent a subgroup of PCOD with deranged regulation of androgen secretion.
女性高雄激素血症常与高胰岛素血症和胰岛素抵抗相关。我们在口服葡萄糖耐量试验中评估了激素反应，以研究多囊卵巢疾病（PCOD）女性中促性腺激素、胰岛素、C肽和雄激素之间的相互作用。在28例经超声诊断为PCOD的患者中，高胰岛素血症和胰岛素抵抗主要与肥胖相关。肥胖受试者的胰岛素与C肽比值的基础值和累积总和均较高，提示肥胖导致肝脏对胰岛素的清除减少。然而，在一些瘦型PCOD女性中，尽管空腹胰岛素浓度正常，但仍存在胰岛素分泌过多的情况。在口服葡萄糖耐量试验期间，PCOD患者和对照女性的睾酮平均浓度均显著降低，仅PCOD患者的雄烯二酮浓度降低。然而，在一组PCOD患者中发现雄激素反应增加，这些患者的促黄体生成素（LH）浓度升高且对口服葡萄糖有高胰岛素血症反应。在其余PCOD患者中，发现LH与胰岛素呈负相关。高胰岛素血症伴LH分泌过多的患者可能代表了雄激素分泌调节紊乱的PCOD亚组。
