ECE2017 Guided Posters Female Reproduction (12 abstracts)
Sensitivity of hypothalamo-pituitary-adrenal axis in women with PCOS
Djuro Macut 1 , Ivana Bozic-Antic 1 , Jelica Bjekic-Macut 2 , Dusan Ilic 1 , Danijela Vojnovic-Milutinovic 3 , Olivera Stanojlovic 4 , Tamara Bogavac 1 , Bojana Popovic 1 , Tatjana Isailovic 1 , Valentina Elezovic 1 & Sanja Ognjanovic 1
1Clinic of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2CHC Bezanijska kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 3IBISS, University of Belgrade, Belgrade, Serbia; 4Institute of Physiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Introduction: Increased adrenal androgen production is present in 20–60% of women with polycistic ovary syndrome (PCOS). Possible mechanism is not clarified yet and could be related to altered hypothalamic-pituitary-adrenal-axis (HPA) activity or a consequence of adrencortical steroidogenic abnormalities. The aim of the study was to assess HPA sensitivity in PCOS women using different doses of dexamethasone.
Methods: We analyzed 359 women with PCOS diagnosed using ESHRE/ASRM criteria (age: 25.6±5.3 years, BMI: 25.1±6.4 kg/m2), and 58 BMI-matched healthy controls (age 28.79±6.1 years, BMI 23.7±6.1 kg/m2). In all subjects serum ACTH, morning serum cortisol (SC), and DHEAS were measured, and SC and DHEAS determined after overnight dexamethasone test with 0.5 mg (Dex0.5mg) and 1 mg (Dex1mg), and marked as SCdex0.5, SCdex1, DHEASdex0.5 and DHEASdex1, respectively. Differences between groups were age adjusted and data are presented as ANCOVA-mean (95%CI).
Results: SC was borderline higher [437.9(421.6–454.3) vs. 395.7(356.7–437.8)nmol/l, P=0.052] and DHEAS significantly higher [7.7(7.3–8.2) vs. 5.6(4.6–6.7)nmol/l, P<0.001] in PCOS than in controls. There was no difference in ACTH among groups. After dexamethasone tests, both groups significantly lowered SC and DHEAS in comparison to basal analyses. In comparison to controls, PCOS had borderline higher SCdex0.5 [49.9 (22.9–76.9) vs. 78.5(67.8–89.1)nmol/l, P=0.055] but similar percentage of SC suppression [86.5 (80.6–92.3) vs. 82.8(80.4–85.3)%, P=0.26]. PCOS had lower SCdex1 [26.8 (23.5–30.2) vs. 22.9(21.6–24.2)nmol/l, P=0.055] and suppressed SC more than controls [92.5(91.6–93.5) vs. 94.5(94.1–94.9)%, P<0.001]. There were no differences in DHEASdex0.5 and DHEASdex1 between groups. Suppression of DHEAS was similar after Dex0.5mg (P=0.92), but PCOS suppressed DHEAS after Dex1mg less than controls [32.1 (25.9–38.3) vs. 47.7(34.0–61.4)%, P=0.04].
Conclusions: Our women with PCOS, in comparison to BMI-matched controls have increased age-adjusted HPA axis sensitivity to 1 mg but not to 0.5 mg of dexamethasone. DHEAS production in PCOS seems to be more independent of ACTH than in controls.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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