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- Title
INSULIN, INDEPENDENT OF SERUM ANDROGENS OR ANDROGEN RECEPTOR CAG REPEAT POLYMORPHISM, IS ASSOCIATED WITH HIRSUTISM IN POLYCYSTIC OVARY SYNDROME.
- Authors
Baculescu, N.; Radian, S.; Gussi, I. L.; Gheorghiu, M.; Coculescu, M.
- Abstract
Background. Hirsutism is part of current criteria of polycystic ovary syndrome (PCOS), as a clinical expression of hyperandrogenism. Objective. To evaluate the significant factors for hirsutism severity in PCOS. Patients. A total of 235 PCOS patients, consecutively coming for medical advice, aged 18-35 yrs, all of Romanian origin, were diagnosed according to Rotterdam criteria. Methods. Hirsutism, quantified using the modified Ferriman-Gallwey (mFG) procedure, was defined by values equal or more than 6. Other parameters evaluated were: body mass index (BMI), fasting insulinemia, insulin resistance quantified by QUICKI, total testosterone (TT), free androgen index (FAI), dehydroepiandrosterone sulfate (DHEAs), 17OH progesterone, fasting glycemia. In a subset of 106 patients, androgen receptor (AR) was explored by CAG repeat genotyping and X-chromosome inactivation analysis. Results. The total PCOS population (235) was divided in group A (n=139, 59.14 %) with hirsutism and group B (n=96, 40.85 %) without hirsutism. In univariate correlations, serum insulin levels (p<0.05) and insulin resistance quantified by QUICKI (p<0.05), but not FAI, TT, DHEAs, 17OH progesterone or BMI were associated significantly with mFG score, in group A of hirsute PCOS patients and also in group B of nonhirsute PCOS. In a stepwise regression mFG model, including TT, insulin and BMI, only insulin remained independently associated with mFG score (p<0.05) in the group A of hirsute PCOS patients, whereas in group B of the nonhirsute PCOS, there were not significant associations. Androgen receptor parameters explored in 106 cases, i.e. by the biallelic means and X-weighted biallelic means of CAGn, did not show significant associations with mFG score in univariate correlations. Only insulin was significantly associated (p<0.05) in another stepwise regression model of mFG including as parameters insulin, TT, biallelic means of CAGn and BMI. Conclusions. Our results support that insulin is significantly associated with the severity of mFG score in PCOS patients, independent of serum androgens or androgen receptor sensitivity expressed by CAGn polymorphism. This suggests a possible pathogenic role of high insulin level for the development and progression of hirsutism, at least in PCOS.
- Subjects
HYPERTRICHOSIS; POLYCYSTIC ovary syndrome; ANDROGEN receptors; HYPERANDROGENISM; X chromosome
- Publication
Acta Endocrinologica (1841-0987), 2012, Vol 8, Issue 3, p413
- ISSN
1841-0987
- Publication type
Article
- DOI
10.4183/aeb.2012.413