Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome  

Oleh:

Brennan, Kathleen ; Huang, Andy ; Azziz, Ricardo

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 91 no. 05 (May 2009), page 1848-1852.
Topik: Polycystic ovary syndrome (PCOS); DHEAS; insulin resistance; adrenal androgens

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2009.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective : To test the hypothesis that increasing DHEAS levels is associated with improved insulin resistance in patients with polycystic ovary syndrome (PCOS). Design : Cross-sectional cohort analysis. Setting : Academic medical center. Patient(s) : Three hundred fifty-two women with PCOS. Intervention(s) : Patients presenting for evaluation of symptoms related to androgen excess were evaluated physically and biochemically through laboratory analysis. Main Outcome Measure(s) : Circulating DHEAS, total T, free T, sex hormone-binding globulin (SHBG), and 17-hydroxyprogesterone (17-OHP) levels, and calculated homeostasis model assessment of insulin resistance (HOMA-IR). Result(s) : Bivariate analysis indicated that all parameters were associated with HOMA-IR, except 17-OHP and age, and confirmed a negative correlation between DHEAS and HOMA-IR. Multivariate analysis indicated that increases in DHEAS, SHBG, 17-OHP, and age were associated with decreasing HOMA-IR, whereas increases in free T, body mass index (BMI), and waist-to-hip ratio (WHR) were associated with increasing HOMA-IR. In decreasing order of importance, the following variables predicted insulin resistance: BMI > WHR > age > DHEAS > free T > SHBG > 17-OHP. Conclusion(s) : DHEAS is negatively correlated to insulin resistance in patients with PCOS, and in our model ranked just behind other well-established predictors including BMI, WHR, and age. Whether this is due to a direct beneficial effect on insulin action by adrenal androgens such as DHEA, or whether DHEAS simply reflects the circulating levels of hyperinsulinemia, remains to be determined.

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