Some of the patients with hyperandrogenemia are characterized by regular cycles and normal ovaries on USG and named as idiopathic hyperandrogenemia (IHA). To clarify the pathophysiology of IHA we have investigated both the adrenal and ovarian functions, and insulin resistance in 20 patients with IHA and 10 healthy women. The study was approved by the local Ethics Committee. The patients have at least one increased serum androgen. ACTH stimulation test, buserelin test and an OGTT were performed. Patients with IHA and healthy women did not differ in age and BMI. Basal DHEAS, 17-OHP, 11-deoxycortisol (11-S), androstenedione and free testosterone levels were significantly (P<0.05) higher in the patients than in the controls. Both peak and area under the curve (AUC) 11-S and AUC DHEAS responses to ACTH test were significantly higher in women with IHA than in the control group (P<0.005). Peak androstenedione, AUC androstenedione and AUC 17-OHP responses after buserelin stimulation were significantly (P<0.05) higher in the patients than in the control women. Fasting blood glucose levels were similar between the groups. Three (15%) of the patients had impaired glucose tolerance (IGT). Basal insulin, peak insulin, AUC insulin responses to OGTT and HOMA-IR were significantly (P<0.005) higher in the patients group than in the controls. The present study clearly shows that high androgen levels in the circulation in IHA patients are in both, adrenal and ovary in origin. A subset of IHA patients are characterized by insulin resistance. Whether IHA is the earliest stage of fullblown PCOS should be clarified by prospective studies.
25 - 29 Apr 2009
European Society of Endocrinology