Session: SUN 498-523-Female Reproductive Endocrinology & Case Reports
Poster Board SUN-504
A. D. Anderson, J. S. P. Collins, R. Bhabhra, C. Burt Solorzano, J. C. Marshall, C. R. McCartney
University of Virginia, Charlottesville, VA
Background: Polycystic ovary syndrome (PCOS) is associated with obesity, insulin resistance, and compensatory hyperinsulinemia. The latter can augment ovarian/adrenal androgen production, but whether short-term hyperinsulinemia can acutely augment HA remains unclear, as studies in adults are contradictory. Many peripubertal girls with obesity (BMI-for-age-percentile [BMI%] >95) demonstrate HA. Fasting insulin predicts free testosterone (T) in obese girls; and weight loss is associated with reduced HA in obese girls. We hypothesized that short-term hyperinsulinemia acutely increases androgens in obese girls. Methods: We studied 11 obese girls: age 12.3 ± 2.4 y; Tanner stage 3.7 ± 1.5; BMI% 98.6 ± 1.0 (reported as mean ± SD). Insulin was measured at least every 30 min for 2 h after a standardized mixed meal (at 1900 h), while fasting (0700-0900 h), and during a 2-h hyperinsulinemic euglycemic clamp (“insulin clamp”). For the clamp, regular human insulin was infused intravenously at 80 mU/m2/min (0900-1100 h), and plasma glucose was maintained via variable infusion of 20% dextrose. The following were measured at the start (0900 h) and end (1100 h) of the clamp: progesterone, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA), androstenedione, T, and estradiol (E2). Wilcoxon signed rank tests were used to compare values at 0900 h to those at 1100 h. Results are reported as mean ± SEM. Results: Mean insulin concentrations (uIU/ml) were 161.9 ± 25.8 after the meal, 25.2 ± 3.2 while fasting, and 162.1 ± 17.2 during the insulin clamp. No significant changes (0900 to 1100 h) were observed for progesterone (0.49 ± 0.06 to 0.53 ± 0.05 ng/ml), 17-OHP (0.90 ± 0.14 to 1.02 ± 0.12 ng/ml), DHEA (8.9 ± 2.9 to 9.5 ± 2.4 ng/ml), or androstenedione (2.1 ± 0.5 to 2.1 ± 0.4 ng/ml). However, both T (39.7 ± 9.4 to 34.7 ± 7.9 ng/dl) and E2 (24.5 ± 3.1 to 19.3 ± 2.0 pg/ml) decreased slightly (p = 0.014 and 0.027, respectively). Conclusions: These data do not support the hypothesis that short-term hyperinsulinemia acutely increases androgens or their precursors in obese girls. Since insulin concentrations during the insulin clamp were similar to those following a standardized meal, it is probable that the insulin clamp did not produce unusual hyperinsulinemia in these subjects. Testosterone and E2 decreased slightly during the clamp; given that both hormones normally demonstrate early morning peaks, the observed changes may reflect normal diurnal variations.
Nothing to Disclose: ADA, JSPC, RB, CMB, JCM, CRM
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