Hyperinsulinemia does not influence androgens/estrogens ratio in patients with polycystic ovarian syndrome

Objective-The ratio of androgens to estrogens in patients with polycystic o varian syndrome (PCOS) and controls was evaluated in order to investigate w hether hyperinsulinemia might induce hyperandrogenemia by decreasing androg en catabolism. Study Design-Forty women were divided into four groups accor ding to the presence of PCOS, insulin resistance, and normal or abnormal bo dy mass index (BMI); each group consisted of 10 women. Group I comprised pa tients with PCOS, insulin resistance, and abnormal BMI. Group II consisted of patients with PCOS, without insulin resistance, and with normal BMI. Gro up III consisted of healthy women (controls) with abnormal BMI. Group TV co nsisted of healthy women with normal BMI. Results-We found that: (1) the me an fasting insulin levels of groups II, III, and IV were significantly lowe r than those of group I (P <.001); (2) serum testosterone levels were signi ficantly lower in groups III and IV than in group I and II; (3) there were no significant differences in serum estradiol and estrone levels between wo men of all groups; (4) women of groups III and IV had significantly lower r atios of testosterone to estradiol at time 0 compared to patients of groups I and II. Conclusion-Our results support the view that since hyperinsuline mia induces hyperandrogenism, the increase of androgens should not be attri buted to the decrease of androgen catabolism.