Sensitivity of plasma insulin levels in obese and non-obese women with functional hyperandrogenism

The effects of somatostatin in the polycystic ovary syndrome

Eighteen obese women (body mass index 30 +/- 6.1 kg/m2) with hyperinsulinaemia and with the polycystic ovary syndrome took octreotide at the dose of 100 mug s.c. The effect of the drug was assessed on plasma levels of gonadotropins luteinising hormone (LH), follicle stimulating hormone (FSH), of insulin, insulin-like growth factor-1 (IGF-1), androstenedione, testosterone, dehydroepiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG) and insulin-like growth factor-binding protein-3 (IGFBP-3). Octreotide significantly reduced LH (31.8%), insulin (52%), IGF-1 (14%), androstenedione (22.6%) and testosterone (20%) and increased IGFBP-3 (25%).

Acne and hirsutism in polycystic ovary syndrome: clinical, endocrine-metabolic and ultrasonographic differences

The aim of this study was to investigate whether the absence or presence of acne or hirsutism in 248 women with polycystic ovary syndrome was associated with different clinical, endocrine, metabolic and ultrasonographic factors. Patients were divided into three groups: 96 (38.7%) without any androgenic symptoms; 94 (37.9%) with only hirsutism; and 58 (23.4%) with only acne. The cycle alterations (oligomenorrhea or amenorrhea) and the echographic ovarian morphology (polycystic or multifollicular ovaries) showed no significant differences between the three groups. Hirsutism was associated with a greater incidence of obesity and insulin resistance, with an increase of 17-hydroxyprogesterone, ovarian and adrenal androgens, 3alpha-androstanediol glucuronide, insulin, insulin-like growth factor-I and low luteinizing hormone, sex hormone binding globulins and insulin-like growth factor binding protein-1 levels. Acne was associated only with the lowest 3alpha-androstanediol glucuronide levels. Therefore, two different pathogenetic mechanisms may play a role in the onset of acne and hirsutism.

Hyperinsulinemia in the polycystic ovary syndrome: a clinical, endocrine and echographic study in 240 patients

In recent years numerous studies have suggested insulin to be an important regulator of ovarian function and hyperinsulinemia to be associated with hyperandrogenism. An oral glucose-tolerance test was carried out in 240 women with polycystic ovary syndrome and, based on its result, 142 of the women (59.2%) were insulin resistant or hyperinsulinemic and 98 (40.8%) were normoinsulinemic. Compared with the normoinsulinemic group, the hyperinsulinemic group had a greater incidence of obesity (52.8 vs. 21.4%), secondary amenorrhea (24.6 vs. 9.2%), androgenic symptoms (85.9 vs. 67.4%) and, in particular, hirsutism with or without acne (71.8 vs. 48.0%). Moreover, the hyperinsulinemic group had significantly higher plasma levels of androstenedione, testosterone, free testosterone and insulin, and lower levels of luteinizing hormone, estradiol and sex hormone-binding globulin.