Investigation of adrenal functions in patients with idiopathic hyperandrogenemia

Some patients with hyperandrogenemia had no identifiable cause, which was named as idiopathic hyperandrogenemia (IHA). The role of the adrenal glands in these patients was investigated.

Clinical study in patients with IHA at the Endocrinology Department of a University Hospital.

In this study, 26 pre-menopausal women with IHA and 20 healthy women were included. Basal hormonal investigations, ACTH test and a 75 g oral glucose tolerance test (OGTT) were performed. Basal levels of total testosterone, free testosterone, androstenedione (A4), sex hormone-binding globulin, DHEA sulfate (DHEAS), cortisol, 17-hydroxyprogesterone (17-OHP), 11-deoxycortisol (11-S) and ACTH-stimulated levels of cortisol, A4, DHEAS, 17-OHP, and 11-S were measured. Additionally, glucose and insulin responses to OGTT were obtained.

The patients and the control subjects had similar age and body mass index. Peak and area under the curve (AUC) responses of 11-S (P<0.05), DHEAS (P<0.005), and A4 (peak, P<0.005; AUC, P<0.001) to ACTH test were significantly higher in the patients with IHA than in the control subjects. There was a significant correlation between the basal DHEAS levels, peak 11-S, and AUC11-S, in response to ACTH-stimulation test in patients with IHA (P<0.005, r, 0.6). Four (16.6%) patients with IHA had glucose intolerance.

Our data suggest that adrenal androgen excess may playanimportant role in patients with IHA and these patients exhibit increased prevalence of glucose intolerance.