INSULIN HYPERSECRETION TOGETHER WITH HIGH LUTEINIZING-HORMONE CONCENTRATION AUGMENTS ANDROGEN SECRETION IN ORAL GLUCOSE-TOLERANCE TEST IN WOMEN WITH POLYCYSTIC OVARIAN DISEASE

Female hyperandrogenism is often associated with hyperinsulinaemia and insulin resistance. We evaluated the hormone responses in an oral glu cose tolerance test to investigate the interactions of gonadotrophins, insulin, C-peptide and androgens in women with polycystic ovarian dis ease (PCOD). In 28 patients with ultrasonographically diagnosed PCOD, hyperinsulinaemia and insulin resistance were mainly associated with o besity. Both basal and cumulative sum of insulin to C-peptide ratios w ere high in obese subjects, suggesting decreasing hepatic removal of i nsulin caused by obesity. Nevertheless, in some lean PCOD women, despi te normal fasting insulin concentrations, insulin hypersecretion exist ed. The mean concentration of testosterone decreased significantly dur ing the oral glucose tolerance test both in PCOD and control women, an d of androstenedione in the PCOD patients only. However, an increase i n androgen responses was found in a subgroup of PCOD patients, who had both elevated luteinizing hormone (LH) concentrations and hyperinsuli naemic response to oral glucose. In the remaining PCOD patients an inv erse correlation between LH and insulin was found. The patients with h yperinsulinaemia together with LH hypersecretion may represent a subgr oup of PCOD with deranged regulation of androgen secretion.