HYPERINSULINEMIA IN POLYCYSTIC-OVARY-SYNDROME - RELATIONSHIP TO CLINICAL AND HORMONAL FACTORS

We analyzed the association between hyperandrogenism and hyperinsuline mia, and their relationship to body mass index, in a large series of p atients with polycystic ovary syndrome (PCOS). A characteristic hormon al profile was sought in women with marked hyperinsulinemia. The patie nt group consisted of 73 women with PCOS, ranging in age from 16 to 29 years. The control group consisted of 34 healthy women with no eviden ce of hyperandrogenism, aged 19-30 years. None of the patients or cont rol women had a body mass index above 27 kg/m(2). Follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, estradiol, and rostenedione, dehydroepiandrosterone sulfate, sex hormone binding glob ulin, 17-hydroxy-progesterone, and free cortisol were determined by ra dioimmunoassay. The free testosterone index was calculated. The oral g lucose tolerance test was used to analyze basal insulinemia, maximum i nsulin peak, and the insulinemia/glycemia index. In the group with PCO S body mass index was greater, free testosterone index was higher, and levels of dehydroepiandrosterone sulfate, testosterone, 17-hydroxypro gesterone (P < 0.001) and androstenedione (P < 0.05) were higher than in the control group. Of the insulin parameters, basal insulinemia, ma ximum insulin peak, and insulinemia/glycemia index were higher in the patient group (P < 0.001). In patients with marked insulinemia, free t estosterone index was more markedly elevated, and gonadotrophin levels were normal. Our data,confirm that a characteristic pattern of hyperi nsulinemia is associated with PCOS. We found no causal relationship be tween hyperinsulinemia and androgen levels. A characteristic hormonal pattern was found in patients with marked hyperinsulinemia.