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ADRENAL FUNCTION IN SUBGROUPS OF THE PCO SYNDROME ASSESSED BY A LONG ACTH TEST
Author(s) -
KANDEEL F. R.,
LONDON D. R.,
BUTT W. R.,
DAVILA N.,
RUDD B. T.,
SADEGHIAN S.,
LYNCH S. S.,
EDWARDS R. LOGAN,
HORDER M.
Publication year - 1980
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1980.tb03429.x
Subject(s) - medicine , endocrinology , dehydroepiandrosterone , testosterone (patch) , group b , polycystic ovary , follicular phase , adrenocorticotropic hormone , androgen , hormone , insulin , insulin resistance
SUMMARY Fifteen patients with the polycystic ovarian (PCO) syndrome were classified into Group A ( n = 6) and Group B ( n = 9) based on their LH responses to LHRH before and at 44 and 92h after administration of oestradiol benzoate. Adrenal function in both groups was assessed by comparing the hormone responses to ACTH (0.5mg twice daily for 4 days) with those obtained in nine normally ovulating women during the early follicular phase of their cycles. In Group A patients there was no significant difference from normals in the serum concentration of dehydroepiandrosterone sulphate (DHAS), 17α‐hydroxy‐progesterone (17‐OHP) or androgens (testosterone and dihydrotestosterone). In contrast, the serum concentrations in Group B were significantly higher ( P <0.01) for each of these steroids before ACTH, and remained higher at 2 and 4 days for DHAS, but not for the other two steroids. The concentration of oestrone was significantly higher ( P <0.05) in Group B patients before, and 2 days after, ACTH, while in Group A patients higher concentrations ( P <0.02) were found only after 2 days. The concentrations of oestradiol, on the other hand, were not different from normal in either group before ACTH and became lower than normal in both groups at 2 days and remained lower at 4 days in Group B. The concentration of cortisol was within the normal range throughout in Group A, but was lower than normal after 4 days in Group B patients ( P <0.05). The ratios between the sums of concentrations of DHAS to cortisol on days 2 and 4 ( P <0.001) or 17‐OHP to cortisol ( P <0.05) were elevated in Group B compared with normal subjects. LH, FSH and prolactin values were normal throughout in Group A, but in Group B patients the mean value for LH was significantly elevated before ACTH and at 4 days after ACTH ( P <0.02).