To investigate whether obese female subjects with abdominal obesity may have adrenal
androgen hypersecretion, we examined two groups of women with abdominal (n = 12) and
peripheral (n = 13) obesity (defined by body mass index and waist-to-hip ratio) and
a group of seven healthy normal-weight women. All subjects underwent the following
protocol study that included a) baseline determination of major adrenal androgens,
b) an ACTH test, performed by administering two boli of ACTH (Synacthen, 0.2 µg/Kg
BW, ev), at 90 min intervals, with blood samples taken for cortisol and androgens,
c) an oral glucose tolerance test, performed by administering glucose (75 gr), with
blood samples taken for glucose and insulin determination. Each woman also underwent
a control saline study. We then investigated the relationships between basal and stimulated
androgen levels, body weight and fat distribution and fasting and stimulated insulin
levels. Although basal cortisol levels were similar, their increase (as AUC) after
the ACTH test was higher in women with abdominal obesity than in the other groups.
On the contrary, there were no significant differences in basal and stimulated serum
levels of dehydroepiandrosterone, androstenedione and 17-hydroxyprogesterone among
the three groups. Fasting and stimulated (as AUC) insulin levels were significantly
higher (p < 0.05) in women with abdominal obesity than in those with peripheral obesity
and controls. No significant correlation was present between basal and stimulated
androgen levels and body mass index, the waist-to-hip ratio or basal and stimulated
cortisol values. Therefore, our data indicate that adrenal androgen secretion following
low-dose ACTH administration in premenopausal women does not seem to be a function
of body fat mass, fat distribution and insulin levels, nor does it correlate with
the capacity of the adrenal glands to secrete cortisol in both basal and stimulated
conditions.
Key words
Adrenal androgens - Abdominal obesity - Insulin
