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  • Title: Impact of glycemic variations on the regulation of androgen metabolism in obese women with polycystic ovary syndrome.
    Author: Ludwig AK, Goharian LG, Dietze T, Tauchert S, Rudolf S, Diedrich K, Schweiger U, Oltmanns KM.
    Journal: Fertil Steril; 2009 Jul; 92(1):271-6. PubMed ID: 18692843.
    Abstract:
    OBJECTIVE: To assess the influence of alterations in glucose concentrations on androgen levels in patients with polycystic ovary syndrome (PCOS) and in healthy controls. DESIGN: Prospective, controlled study. SETTING: Tertiary care center. PATIENT(S): Seven patients with PCOS and 20 healthy controls. INTERVENTION(S): Hyperinsulinemic glucose clamp study with stepwise reduction of the plasma glucose level from hyperglycemia to hypoglycemia. MAIN OUTCOME MEASURE(S): Concentrations of insulin, C-peptide, cortisol, T, androstenedione, 17-hydroxyprogesterone, DHEA, and DHEAS during hyperglycemia, euglycemia, and hypoglycemia. RESULT(S): Total T levels and the free androgen index were significantly higher in the PCOS group at baseline and throughout the clamp. The levels of T, androstenedione, DHEAS, and 17-hydroxyprogesterone were not influenced by short-term changes of plasma glucose concentrations in both groups. However, hypoglycemia led to a significant increase in DHEA levels in PCOS patients as well as in controls. Cortisol levels were not increased during hypoglycemia in either group. CONCLUSION(S): In contrast to men, androgen levels are not influenced by short-term changes of plasma glucose levels in PCOS patients and in healthy women. However, DHEA concentrations increase with decreasing glucose levels independently from an activation of the hypothalamic-pituitary-adrenal axis. This supports a gender difference regarding the counterregulatory hormone response to hypoglycemia.
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