Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is characterized by menstrual disorders, hyperandrogenism and polycystic ovaries on ultrasonography. This hormonal disorder is also strongly associated with insulin resistance. The diagnosis of PCOS can be established after the exclusion of other causes of mentioned symptoms, such as non-classic congenital adrenal hyperplasia (NCAH). To date, several studies suggest the increased serum concentration of 17-hydroxyprogesterone (17-OHP) in PCOS, even in the absence of NCAH; however, its impact on glucose metabolism has not been discussed widely in the literature.

Aim of the study: The aim of the study was the evaluation of serum 17-OHP and dehydroepiandrosterone sulfate (DHEA-S) concentrations in women with PCOS and the assessment of their relation to the parameters of glucose metabolism.

Materials and methods: We analyzed 35 PCOS women and 19 control subjects, matched for BMI (24.87±4.51 kg/m2) and age (25.35±4.56 y.o.). In women with PCOS, NCAH was excluded by the ACTH stimulation test. The participants were reviewed for anthropometric measurements, the clinical signs of hyperandrogenism, complex hormonal profile, oral glucose tolerance test (OGTT) and ovarian ultrasound parameters. The increase in 17-OHP concentrations in the ACTH-stimulation test (17-OHP delta value), the homeostasis model assessment of insulin resistance (HOMA-IR), Matsuda index and free androgen index (FAI) were calculated.

Results: The women with PCOS were distinguished by statistically higher baseline concentration of 17-OHP, FAI, the level of DHEA-S, serum glucose concentrations at 60 min and 120 min of OGTT, as well as insulin concentration at 120 min of OGTT (all P<0.01) and higher testosterone level (P=0.014) in comparison to the control group. In PCOS-affected women, we found the correlation between the 17-OHP delta value and Matsuda index (r=-0.77, P=0.002), as well as testosterone and insulin at 60 min of OGTT (r=0.5, P=0.042). Moreover, we observed that FAI correlated with fasting insulin concentration (r=0.76, P<0.001), as well as HOMA-IR (r=0.67, P=0.005). Additionally, in a whole study group, we observed the correlation between glucose concentration at 60 min of OGTT and baseline level of 17-OHP (r=0.39, P=0.006), 17-OHP delta value (r=0.44, P=0.017), testosterone (r=0.29, P=0.048), FAI (r=0.4, P=0.016) and DHEA-S (r=0.34, P=0.049). We also found the relationship between DHEA-S and insulin concentration at 120 min of OGTT (r=0.34, P=0.049), as well as the baseline level of 17-OHP (r=0.48, P=0.004) in a whole study group.

Conclusion: Serum 17-OHP and DHEA-S concentrations are elevated in PCOS-affected women and their levels might be related to the parameters of glucose metabolism.