Hyperinsulinemia does not Acutely Enhance Adrenal Androgen Production in Women or Men

Introduction

Polycystic ovary syndrome (PCOS) affects 4-7% of reproductive aged women, making it the most common female endocrinopathy. Androgen excess is seen in the vast majority of women with PCOS and is thought to be primarily of ovarian origin with an adrenal contribution in 25-60% of cases [1]. The mediator of this dysregulated adrenal steroidogenesis remains unclear, but one possibility is hyperinsulinemia, which occurs in 50-70% of women with PCOS [2] [3]. In vitro studies in normal adrenocortical cells have demonstrated insulin-induced increases in adrenal steroidogenic enzyme mRNA [4]. In vivo studies have yielded conflicting results of insulin's effects on adrenal steroidogenesis. The purpose of this investigation was to assess the effects of acute hyperinsulinemia on adrenal steroidogenesis in healthy adults.

References

• 1 Moran C, Reyna R, Boots LS, Azziz R. Fertil Steril. 2004;  81 126-131
• 2 Ovalle F, Azziz R. Fertil Steril. 2002;  77 1095-1105
• 3 Yilmaz M, Biri A, Karakoc A, Toruner F, Bingol B, Cakir N, Tiras B, Ayvaz G, Arslan M. J Endocrinol Invest. 2005;  28 1003-1008
• 4 Kristiansen SB, Endoh A, Casson PR, Buster JE, Hornsby PJ. Steroids. 1997;  62 258-265
• 5 Diamond MP, Grainger DA, Laudano AJ, Starick-Zych K, DeFronzo RA. J Clin Endocrinol Metab. 1991;  72 883-887
• 6 Dunaif A, Graf M. J Clin Invest. 1989;  83 23-29
• 7 Stuart CA, Nagamani M. Fertil Steril. 1990;  54 788-792
• 8 Lavallee B, Provost PR, Kahwash Z, Nestler JE, Belanger A. Clin Endocrinol (Oxf). 1997;  46 93-100
• 9 Nestler JE, Singh R, Matt DW, Clore JN, Blackard WG. Am J Obstet Gynecol. 1990;  163 1243-1246
• 10 Nestler JE, Barlascini CO, Matt DW, Steingold KA, Plymate SR, Clore JN, Blackard WG. J Clin Endocrinol Metab. 1989;  68 1027-1032
• 11 Nestler JE, Powers LP, Matt DW, Steingold KA, Plymate SR, Rittmaster RS, Clore JN, Blackard WG. J Clin Endocrinol Metab. 1991;  72 83-89
• 12 Pasquali R, Casimirri F, Iasio R De, Mesini P, Boschi S, Chierici R, Flamia R, Biscotti M, Vicennati V. J Clin Endocrinol Metab. 1995;  80 654-658
• 13 Pasquali R, Macor C, Vicennati V, Novo F, Lasio R De, Mesini P, Boschi S, Casimirri F, Vettor R. Metabolism. 1997;  46 526-529
• 14 Poretsky L, Cataldo NA, Rosenwaks Z, Giudice LC. Endocr Rev. 1999;  20 535-582
• 15 Guido M, Romualdi D, Suriano R, Giuliani M, Costantini B, Apa R, Lanzone A. Hum Reprod. 2004;  19 534-539
• 16 Aedo AR, Nunez M, Landgren BM, Cekan SZ, Diczfalusy E. Acta Endocrinol (Copenh). 1977;  84 320-332

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