Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome.

Abstract

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.

• Authors: Kathleen Brennan, Andy Huang, Ricardo Azziz
• Journal: Fertility and sterility (Fertil Steril) Vol. 91 Issue 5 Pg. 1848-52 (May 2009) ISSN: 1556-5653 [Electronic] United States
• PMID: 18439591 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Sex Hormone-Binding Globulin
• Testosterone
• Dehydroepiandrosterone Sulfate
• 17-alpha-Hydroxyprogesterone

Topics

• 17-alpha-Hydroxyprogesterone (blood)
• Adult
• Body Mass Index
• Cohort Studies
• Cross-Sectional Studies
• Dehydroepiandrosterone Sulfate (blood)
• Female
• Humans
• Insulin Resistance
• Polycystic Ovary Syndrome
• Sex Hormone-Binding Globulin (analysis)
• Testosterone (blood)
• Waist-Hip Ratio