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Suppression of Serum Insulin by Diazoxide Reduces Serum Testosterone Levels in Obese Women with Polycystic Ovary Syndrome*

1989; Oxford University Press; Volume: 68; Issue: 6 Linguagem: Inglês

10.1210/jcem-68-6-1027

1945-7197

John E. Nestler, Cornelius Barlascini, Dennis W. Matt, Kenneth A. Steingold, Stephen R. Plymate, John N. Clore, William G. Blackard,

Hypothalamic control of reproductive hormones

To test the hypothesis that insulin plays a role in the hyperandrogenism of obese women with polycystic ovary syndrome, we conducted a prospective study in which the androgen status of five obese women with polycystic ovary syndrome was assessed on two occasions: before and after 10 days of oral diazoxide (100 mg, three times daily) administration. Fasting serum insulin levels decreased from 177 ± 45 (±SE) to 123 ± 43 pmol±L (P < 0.01) and insulin release in response to 100 g oral glucose administration decreased from 223.0 ± 29.2 to 55.6 ± 7.9 nmol·min±L (P < 0.002) after diazoxide administration. At the same time, serum total testosterone fell from 2.5 ± 0.4 to 2.1 ± 0.3 nmol±L (P < 0.007), serum testosterone not bound to sex hormone-binding globulin fell from 1.9 ± 0.3 to 1.4 ± 0.2 nmol± L (P < 0.01), and the molar ratio of serum androstenedione to serum estrone fell from 25.7 ± 7.7 to 16.6 ± 5.5 (P < 0.04). Serum sex hormone-binding globulin levels increased slightly but not significantly from 13.2 ± 1.0 to 21.7 ± 4.1 nmol±L. Serum androstenedione, dehydroepiandrosterone sulfate, estradiol, estrone, and progesterone concentrations did not change, nor did basal or GnRH-stimulated serum LH and FSH concentrations. These results suggest that hyperinsulinemia in obese women with polycystic ovary syndrome may directly increase serum testosterone levels.