Diagnosis of polycystic ovary disease in obese women with a 24-hour hormone profile after buserelin stimulation

OBJECTIVE: To evaluate the 24-hour hormone response to GnRH agonist stimula tion in the diagnosis of polycystic ovary disease (PCOD) in obese women. STUDY DESIGN: Forty-three obese PCOD patients and 23 controls were randomiz ed to 1 mg buserelin (BSRL) stimulation (PCOD group P-1, n = 31; control gr oup C-l, n = 12) or 0.1 mg (PCOD group P-0.1, n = 12; control group C-0.1, n = 11). RESULTS: Whereas following I mg BSRL administration, serum levels of 17 hyd roxyprogesterone (17OHP), Delta(4) androstenedione, estradiol (E-2) and lut einizing hormone increment (Delta LH) as well as the Delta LH/Delta follicl e stimulating hormone ratio were all higher in group P-l than in group C-l (P < .001, < .01, < .011 = .08 and < .001, re spectively), only 17OHP and E -2 serum levels were higher in group P-0.1 than in group C-0.1 (P < .001, a nd .01, respectively). Whereas 24-hour LH inversely correlated with body ma ss index (r = .37, P = .04), 24-hour hormone profile, and basal or glucose- stimulated serum insulin levels did not correlate in group P-I. CONCLUSION: The 1-mg BSRL stimulation test is a convenient diagnostic means in obesity-associated PCOD. The hormone response to BSRL administration is related to obesity, not to insulin resistance.