LACK OF RELATIONSHIP BETWEEN 17-HYDROXYPROGESTERONE RESPONSE TO BUSERELIN TESTING AND HYPERINSULINEMIA IN POLYCYSTIC-OVARY-SYNDROME

Objective: To determine whether hyperinsulinism affects cytochrome P45 0c17 alpha activity by investigating the correlation between 17-hydrox yprogesterone (17-OHP) hyper-responsiveness to the gonadotropin-releas ing hormone (GnRH) agonist, buserelin, and the insulin response to ora l glucose in polycystic ovary syndrome (PCOS). Design: Ultrasound, cli nical and hormonal parameters were used to define PCOS in this prospec tive clinical study. We investigated the correlation between the 17-OH P response to buserelin testing and the insulin response to oral gluco se in PCOS, Methods: Twenty-eight women with PCOS and eighteen normal women were included in the study. 17-OHP response to buserelin, and in sulin and C-peptide responses to oral glucose were measured, Results: Twenty-five women with PCOS had an increased 17-OHP response. The PCOS patients showed significantly higher mean post-glucose load insulin a nd C-peptide levels than controls (P<0.05). No significant correlation s were found between basal 17-OHP and fasting insulin or fasting C-pep tide, between peak 17-OHP and fasting insulin, peak insulin or peak C- peptide, between 17-OHP area under the curve (AUG) and insulin AUC or C-peptide AUC, and between percent increment in 17-OHP and insulin AUC or C-peptide AUC (P>0.05), Conclusions: Lack of a relationship betwee n the 17-OHP response to the GnRH agonist buserelin and hyperinsulinis m suggests that hyperinsulinism mag not play a role in the dysregulati on of the cytochrome P450c17 alpha enzyme seen in PCOS.