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NEUROENDOCRINOLOGY
LETTERS
including
Psychoneuroimmunology, Neuropsychopharmacology,
Reproductive Medicine, Chronobiology
and Human Ethology, ISSN 0172–780X
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NEL
Vol.24 Nos.3/4, Jun-Aug 2003
ORIGINAL ARTICLE
Running
Title:
Pituitary-adrenal axis in PCOS
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2003;
24:249–254
pii: NEL243403A16
PMID: 14523365
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Evaluation
of the Pituitary-adrenal axis in hyperandrogenic women with
polycystic ovary syndrome
Rafael
Luboshitzky 1,3, Abraham Ishai 1, Zila Shen-Or
2 & Paula Herer 3
1.
Endocrine Institute, Haemek Medical Center, Afula (RL, AI),
2. Endocrine Laboratory, Rambam Medical Center, Haifa (ZSO),
and
3. the B.Rappaport Faculty of Medicine, Technion, Israel Institute
of Technology, Haifa, Israel
Submitted:
February 24, 2003
Accepted: March 12, 2003
Key
words:
ACTH test, cortisol, 17-hydroxyprogesterone, polycystic
ovary syndrome
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Abstract
Objectives:
Impaired adrenal function is common in patients with polycystic
ovary syndrome (PCOS). Abnormal regulation of cytochrome P450
17 alpha is believed to cause the exaggerated 17-hydroxyprogesterone
(17OHP) response to ACTH stimulation. The aim of the study
was to evaluate cortisol and 17OHP response to low dose (1
mg) ACTH test and to compare it with the standard ACTH (250
mg) test in hyperandrogenic women with PCOS.
Design
and measurements: We studied 27 PCOS and 22 control women.
All participants were examined for mutations of the CYP21
gene, Cortisol and 17OHP levels before, 30 and 60 minutes
after the IV injection of 250 mg ACTH (SDT) and after 1 mg
ACTH (LDT). Fasting serum levels of LH, FSH, testosterone,
DHEAS were determined in all participants.
Results: Basal and ACTH stimulated Cortisol during the SDT
(470±138 nmol/L and 761±143, respectively) were
significantly higher in PCOS vs. controls (232±124
and 670±130, respectively) (p<0.03, p<0.02, respectively).
Basal 17OHP (6.1±2.1 nmol/L) and the peak response
to SDT (14.2±3.6 nmol/L) were significantly higher
in PCOS vs. controls (4.2±2.1, 10.9±3.0, respectively)
(p<0.003, p<0.004, respectively). Abnormally elevated
17OHP response to SDT was detected in 6/27 PCOS women (22%).
No statistically significant difference between the PCOS and
control groups were noted during the LDT in both cortisol
and 17OHP levels.
Conclusions:
These data suggest that the exaggerated 17-hydroxyprogesterone
(17OHP) response to ACTH stimulation in PCOS is revealed by
stimulation at a pharmacological dose (250 mg) but not by
a physiological dose (1 mg).
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__________________________________________________________
Copyright © Neuroendocrinology Letters 2003
Society of Integrated Sciences
All rights reserved. No part may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording, or ortherwise,
without prior written permission from the Editor-in-Chief.
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