GONADOTROPIN-LEVELS IN WOMEN WITH POLYCYSTIC-OVARY-SYNDROME - THEIR RELATIONSHIP TO BODY-WEIGHT AND INSULIN LEVELS

The purpose of this work was to investigate the relationship of gonado tropin levels to body weight and insulin levels in women with polycyst ic ovary syndrome (PCOS). Specifically, we wished to test the hypothes is that circulating luteinizing hormone (LH) and insulin levels are di fferent in obese and normal weight patients with PCOS. The basal plasm a levels of gonadotropins, estrogens, androgens and sex hormone-bindin g globulin, the gonadotropin responses to gonadotropin releasing hormo ne (GnRH) and the insulin and C-peptide responses to a 3-hour oral glu cose tolerance test (OGTT) were measured in 19 obese and 19 normal wei ght patients with PCOS and 7 obese and 8 normal weight ovulatory contr ols. Data of the patients were evaluated according to body weight (obe se vs normal weight) and basal LH (high vs normal). There was no signi ficant difference in basal LH and androgen levels and in the insulin r esponse to oral glucose between obese and normal weight patients with PCOS. Compared to the weight matched controls, both obese and non obes e patients showed significantly higher LH responses to GnRH and C-pept ide responses to OGTT. When the high LH patients (no=18) were compared those with normal LH (no=20), the high LH subjects exhibited signific antly higher androstenedione levels. Both obese (no=10) and normal wei ght (no=8) patients with high LH showed significantly greater C-peptid e responses to OGTT than obese (no=9) and non obese (no=11) patients w ith normal LH. However, as compared with the weight matched controls, both the high LH and normal LH patients had significantly greater C-pe ptide responses to OGTT. We conclude that obese and non obese patients with PCOS do not seem to differ in the prevalence of elevated LH leve ls or in the LH secretory pattern. Insulin resistance, expressed by an enhanced pancreatic sensitivity to oral glucose, is present in both t he high LH and the normal LH subjects, even though the PCOS patients w ith elevated LH tend to be more insulin resistant and hyperandrogenic than the normal LH patients.