Reproductive Medicine, Chronobiology
and Human Ethology, ISSN 0172780X
Vol.24 Nos.3/4, Jun-Aug 2003
Pituitary-adrenal axis in PCOS
of the Pituitary-adrenal axis in hyperandrogenic women with
polycystic ovary syndrome
Luboshitzky 1,3, Abraham Ishai 1, Zila Shen-Or
2 & Paula Herer 3
Endocrine Institute, Haemek Medical Center, Afula (RL, AI),
2. Endocrine Laboratory, Rambam Medical Center, Haifa (ZSO),
3. the B.Rappaport Faculty of Medicine, Technion, Israel Institute
of Technology, Haifa, Israel
February 24, 2003
Accepted: March 12, 2003
ACTH test, cortisol, 17-hydroxyprogesterone, polycystic
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.
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.
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).
Copyright © Neuroendocrinology Letters 2003
Society of Integrated Sciences
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