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Adrenal dynamic responses to physiologic and pharmacologic adrenocorticotropic hormone stimulation before and after ovarian steroid modulation in women with polycystic ovary syndrome
Objective: To test the hypothesis that in women with polycystic ovary syndrome (PCOS), adrenal cytochrome P450c 17α activity is different after physiologic vs. pharmacologic ACTH stimulation and that ovarian activity promotes adrenal hyperactivity that is different after physiologic vs. pharmacologi...
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| Published in: | Fertility and sterility 1999-03, Vol.71 (3), p.439-444 |
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| cites | cdi_FETCH-LOGICAL-c437t-180c2ba75e003ac46d982a80abce3990bd3eeb763c513d084ea8ea6990d845e3 |
| container_end_page | 444 |
| container_issue | 3 |
| container_start_page | 439 |
| container_title | Fertility and sterility |
| container_volume | 71 |
| creator | Gonzalez, Frank Chang, Lillie Horab, Theresa Stanczyk, Frank Z Crickard, Kent Lobo, Rogerio A |
| description | Objective: To test the hypothesis that in women with polycystic ovary syndrome (PCOS), adrenal cytochrome P450c 17α activity is different after physiologic vs. pharmacologic ACTH stimulation and that ovarian activity promotes adrenal hyperactivity that is different after physiologic vs. pharmacologic ACTH stimulation.
Design: Prospective controlled pilot study.
Setting: Reproductive endocrinology unit of an academic medical center.
Patient(s): Six women with PCOS who had adrenal hyperandrogenism were compared with four women with normal ovulation.
Intervention(s): Adrenal dynamic blood sampling was performed before and after 6 months of GnRH agonist administration.
Main Outcome Measure(s): Comparison of physiologic and pharmacologic ACTH-stimulated levels of progesterone, 17-hydroxyprogesterone, and androgens before and after ovarian steroid modulation.
Result(s): In women with PCOS, exaggerated responses of androstenedione and 11β-hydroxyandrostenedione as well as elevated ratios of 17-hydroxyprogesterone to progesterone and of androstenedione to 17-hydroxyprogesterone after physiologic ACTH stimulation did not persist after GnRH-agonist administration. Three of the six women with PCOS had an increased response of androstenedione and a ratio of androstenedione to 17-hydroxyprogesterone that were >2 SD above the mean of those in the women with normal ovulation after pharmacologic ACTH stimulation; this finding persisted after GnRH-agonist administration.
Conclusion(s): In women with PCOS, increases in adrenal androgen sensitivity after physiologic ACTH stimulation reflected in both arms of cytochrome P450c 17α activity may be influenced by ovarian activity. However, 17,20-lyase hyperactivity in a subset after pharmacologic ACTH stimulation may be an intrinsic adrenal disorder. |
| doi_str_mv | 10.1016/S0015-0282(98)00469-5 |
| format | article |
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Design: Prospective controlled pilot study.
Setting: Reproductive endocrinology unit of an academic medical center.
Patient(s): Six women with PCOS who had adrenal hyperandrogenism were compared with four women with normal ovulation.
Intervention(s): Adrenal dynamic blood sampling was performed before and after 6 months of GnRH agonist administration.
Main Outcome Measure(s): Comparison of physiologic and pharmacologic ACTH-stimulated levels of progesterone, 17-hydroxyprogesterone, and androgens before and after ovarian steroid modulation.
Result(s): In women with PCOS, exaggerated responses of androstenedione and 11β-hydroxyandrostenedione as well as elevated ratios of 17-hydroxyprogesterone to progesterone and of androstenedione to 17-hydroxyprogesterone after physiologic ACTH stimulation did not persist after GnRH-agonist administration. Three of the six women with PCOS had an increased response of androstenedione and a ratio of androstenedione to 17-hydroxyprogesterone that were >2 SD above the mean of those in the women with normal ovulation after pharmacologic ACTH stimulation; this finding persisted after GnRH-agonist administration.
Conclusion(s): In women with PCOS, increases in adrenal androgen sensitivity after physiologic ACTH stimulation reflected in both arms of cytochrome P450c 17α activity may be influenced by ovarian activity. However, 17,20-lyase hyperactivity in a subset after pharmacologic ACTH stimulation may be an intrinsic adrenal disorder.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/S0015-0282(98)00469-5</identifier><identifier>PMID: 10065779</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>20-lyase hyperactivity ; adrenal androgen sensitivity ; adrenal dynamic testing ; Adrenocorticotropic Hormone - blood ; Adult ; Biological and medical sciences ; Cosyntropin - therapeutic use ; Female ; Female genital diseases ; GnRH agonist ; Gonadotropin-Releasing Hormone - agonists ; Gynecology. Andrology. Obstetrics ; Hormones - blood ; Humans ; Hyperandrogenism - complications ; Leuprolide - therapeutic use ; Medical sciences ; Ovary - physiology ; Pilot Projects ; Polycystic ovary syndrome ; Polycystic Ovary Syndrome - blood ; Polycystic Ovary Syndrome - complications ; Polycystic Ovary Syndrome - drug therapy ; Polycystic Ovary Syndrome - enzymology ; Steroid 17-alpha-Hydroxylase - metabolism ; Tumors</subject><ispartof>Fertility and sterility, 1999-03, Vol.71 (3), p.439-444</ispartof><rights>1999 American Society for Reproductive Medicine</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-180c2ba75e003ac46d982a80abce3990bd3eeb763c513d084ea8ea6990d845e3</citedby><cites>FETCH-LOGICAL-c437t-180c2ba75e003ac46d982a80abce3990bd3eeb763c513d084ea8ea6990d845e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028298004695$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,786,790,3568,27957,27958,45815</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1901945$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10065779$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gonzalez, Frank</creatorcontrib><creatorcontrib>Chang, Lillie</creatorcontrib><creatorcontrib>Horab, Theresa</creatorcontrib><creatorcontrib>Stanczyk, Frank Z</creatorcontrib><creatorcontrib>Crickard, Kent</creatorcontrib><creatorcontrib>Lobo, Rogerio A</creatorcontrib><title>Adrenal dynamic responses to physiologic and pharmacologic adrenocorticotropic hormone stimulation before and after ovarian steroid modulation in women with polycystic ovary syndrome</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective: To test the hypothesis that in women with polycystic ovary syndrome (PCOS), adrenal cytochrome P450c 17α activity is different after physiologic vs. pharmacologic ACTH stimulation and that ovarian activity promotes adrenal hyperactivity that is different after physiologic vs. pharmacologic ACTH stimulation.
Design: Prospective controlled pilot study.
Setting: Reproductive endocrinology unit of an academic medical center.
Patient(s): Six women with PCOS who had adrenal hyperandrogenism were compared with four women with normal ovulation.
Intervention(s): Adrenal dynamic blood sampling was performed before and after 6 months of GnRH agonist administration.
Main Outcome Measure(s): Comparison of physiologic and pharmacologic ACTH-stimulated levels of progesterone, 17-hydroxyprogesterone, and androgens before and after ovarian steroid modulation.
Result(s): In women with PCOS, exaggerated responses of androstenedione and 11β-hydroxyandrostenedione as well as elevated ratios of 17-hydroxyprogesterone to progesterone and of androstenedione to 17-hydroxyprogesterone after physiologic ACTH stimulation did not persist after GnRH-agonist administration. Three of the six women with PCOS had an increased response of androstenedione and a ratio of androstenedione to 17-hydroxyprogesterone that were >2 SD above the mean of those in the women with normal ovulation after pharmacologic ACTH stimulation; this finding persisted after GnRH-agonist administration.
Conclusion(s): In women with PCOS, increases in adrenal androgen sensitivity after physiologic ACTH stimulation reflected in both arms of cytochrome P450c 17α activity may be influenced by ovarian activity. However, 17,20-lyase hyperactivity in a subset after pharmacologic ACTH stimulation may be an intrinsic adrenal disorder.</description><subject>20-lyase hyperactivity</subject><subject>adrenal androgen sensitivity</subject><subject>adrenal dynamic testing</subject><subject>Adrenocorticotropic Hormone - blood</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cosyntropin - therapeutic use</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>GnRH agonist</subject><subject>Gonadotropin-Releasing Hormone - agonists</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hormones - blood</subject><subject>Humans</subject><subject>Hyperandrogenism - complications</subject><subject>Leuprolide - therapeutic use</subject><subject>Medical sciences</subject><subject>Ovary - physiology</subject><subject>Pilot Projects</subject><subject>Polycystic ovary syndrome</subject><subject>Polycystic Ovary Syndrome - blood</subject><subject>Polycystic Ovary Syndrome - complications</subject><subject>Polycystic Ovary Syndrome - drug therapy</subject><subject>Polycystic Ovary Syndrome - enzymology</subject><subject>Steroid 17-alpha-Hydroxylase - metabolism</subject><subject>Tumors</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><recordid>eNqFkctu1TAQhi0EoofCI4C8QAgWATuJnXhVVVW5SJVY0L3l2BOOUeIJtk9RXoznq8-lwI6NLzPf_3vkn5CXnL3njMsP3xjjomJ1X79V_TvGWqkq8YhsuBCyElI0j8nmD3JGnqX0gzEmeVc_JWe8nETXqQ35fekiBDNRtwYze0sjpAVDgkQz0mW7Jo8Tfi8NE1y5mzgb-1DZS9FizN5ijriU2hbjjAFoyn7eTSZ7DHSAESMcDMyYIVK8M9GbUCCI6B2d0T2wPtBfOENZfd7SBafVrsXLHjQrTWtwsfSfkyejmRK8OO3n5Pbj9e3V5-rm66cvV5c3lW2bLle8Z7YeTCeAscbYVjrV16ZnZrDQKMUG1wAMnWys4I1jfQumByNLx_WtgOacvDnaLhF_7iBlPftkYZpMANwlLZUsn8rrAoojaCOmFGHUS_RzmVhzpvd56UNeeh-GVr0-5KVF0b06PbAbZnD_qI4BFeD1CTDJmmmMJlif_nKKcdXufS6OGJTPuPMQdbIeggXnI9isHfr_THIPpQ24pA</recordid><startdate>19990301</startdate><enddate>19990301</enddate><creator>Gonzalez, Frank</creator><creator>Chang, Lillie</creator><creator>Horab, Theresa</creator><creator>Stanczyk, Frank Z</creator><creator>Crickard, Kent</creator><creator>Lobo, Rogerio A</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990301</creationdate><title>Adrenal dynamic responses to physiologic and pharmacologic adrenocorticotropic hormone stimulation before and after ovarian steroid modulation in women with polycystic ovary syndrome</title><author>Gonzalez, Frank ; Chang, Lillie ; Horab, Theresa ; Stanczyk, Frank Z ; Crickard, Kent ; Lobo, Rogerio A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-180c2ba75e003ac46d982a80abce3990bd3eeb763c513d084ea8ea6990d845e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>20-lyase hyperactivity</topic><topic>adrenal androgen sensitivity</topic><topic>adrenal dynamic testing</topic><topic>Adrenocorticotropic Hormone - blood</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cosyntropin - therapeutic use</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>GnRH agonist</topic><topic>Gonadotropin-Releasing Hormone - agonists</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hormones - blood</topic><topic>Humans</topic><topic>Hyperandrogenism - complications</topic><topic>Leuprolide - therapeutic use</topic><topic>Medical sciences</topic><topic>Ovary - physiology</topic><topic>Pilot Projects</topic><topic>Polycystic ovary syndrome</topic><topic>Polycystic Ovary Syndrome - blood</topic><topic>Polycystic Ovary Syndrome - complications</topic><topic>Polycystic Ovary Syndrome - drug therapy</topic><topic>Polycystic Ovary Syndrome - enzymology</topic><topic>Steroid 17-alpha-Hydroxylase - metabolism</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonzalez, Frank</creatorcontrib><creatorcontrib>Chang, Lillie</creatorcontrib><creatorcontrib>Horab, Theresa</creatorcontrib><creatorcontrib>Stanczyk, Frank Z</creatorcontrib><creatorcontrib>Crickard, Kent</creatorcontrib><creatorcontrib>Lobo, Rogerio A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonzalez, Frank</au><au>Chang, Lillie</au><au>Horab, Theresa</au><au>Stanczyk, Frank Z</au><au>Crickard, Kent</au><au>Lobo, Rogerio A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adrenal dynamic responses to physiologic and pharmacologic adrenocorticotropic hormone stimulation before and after ovarian steroid modulation in women with polycystic ovary syndrome</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>1999-03-01</date><risdate>1999</risdate><volume>71</volume><issue>3</issue><spage>439</spage><epage>444</epage><pages>439-444</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><abstract>Objective: To test the hypothesis that in women with polycystic ovary syndrome (PCOS), adrenal cytochrome P450c 17α activity is different after physiologic vs. pharmacologic ACTH stimulation and that ovarian activity promotes adrenal hyperactivity that is different after physiologic vs. pharmacologic ACTH stimulation.
Design: Prospective controlled pilot study.
Setting: Reproductive endocrinology unit of an academic medical center.
Patient(s): Six women with PCOS who had adrenal hyperandrogenism were compared with four women with normal ovulation.
Intervention(s): Adrenal dynamic blood sampling was performed before and after 6 months of GnRH agonist administration.
Main Outcome Measure(s): Comparison of physiologic and pharmacologic ACTH-stimulated levels of progesterone, 17-hydroxyprogesterone, and androgens before and after ovarian steroid modulation.
Result(s): In women with PCOS, exaggerated responses of androstenedione and 11β-hydroxyandrostenedione as well as elevated ratios of 17-hydroxyprogesterone to progesterone and of androstenedione to 17-hydroxyprogesterone after physiologic ACTH stimulation did not persist after GnRH-agonist administration. Three of the six women with PCOS had an increased response of androstenedione and a ratio of androstenedione to 17-hydroxyprogesterone that were >2 SD above the mean of those in the women with normal ovulation after pharmacologic ACTH stimulation; this finding persisted after GnRH-agonist administration.
Conclusion(s): In women with PCOS, increases in adrenal androgen sensitivity after physiologic ACTH stimulation reflected in both arms of cytochrome P450c 17α activity may be influenced by ovarian activity. However, 17,20-lyase hyperactivity in a subset after pharmacologic ACTH stimulation may be an intrinsic adrenal disorder.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10065779</pmid><doi>10.1016/S0015-0282(98)00469-5</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Fertility and sterility, 1999-03, Vol.71 (3), p.439-444 |
| issn | 0015-0282 1556-5653 |
| language | eng |
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| source | ScienceDirect® |
| subjects | 20-lyase hyperactivity adrenal androgen sensitivity adrenal dynamic testing Adrenocorticotropic Hormone - blood Adult Biological and medical sciences Cosyntropin - therapeutic use Female Female genital diseases GnRH agonist Gonadotropin-Releasing Hormone - agonists Gynecology. Andrology. Obstetrics Hormones - blood Humans Hyperandrogenism - complications Leuprolide - therapeutic use Medical sciences Ovary - physiology Pilot Projects Polycystic ovary syndrome Polycystic Ovary Syndrome - blood Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - drug therapy Polycystic Ovary Syndrome - enzymology Steroid 17-alpha-Hydroxylase - metabolism Tumors |
| title | Adrenal dynamic responses to physiologic and pharmacologic adrenocorticotropic hormone stimulation before and after ovarian steroid modulation in women with polycystic ovary syndrome |
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