Investigation of hypothalamo-pituitary-gonadal axis and glucose intolerance among the first-degree female relatives of women with polycystic ovary syndrome

Objective

To assess the glucose intolerance and the hypothalamo-pituitary-gonadal (HPG) axis in the first-degree relatives (FDRs) of patients with polycystic ovary syndrome (PCOS).

Design

Clinical study of the female FDRs of patients with PCOS.

Setting

Outpatients at endocrinology department of a university hospital.

Patient(s)

Seventy FDRs of PCOS patients and 20 healthy women were evaluated.

Intervention(s)

Basal hormonal investigations, buserelin test, and 75-g oral glucose tolerance test (OGTT) were performed.

Main Outcome Measure(s)

Basal hormone levels were measured. Additionally, insulinogenic index, glucose and insulin responses to OGTT, and FSH, LH, E₂, and 17-OHP responses to buserelin test were obtained.

Result(s)

Four (5.7%) of the FDRs showed impaired glucose tolerance, and the FDRs had significantly higher fasting plasma glucose (P<.05) and basal insulin (P<.01) than control subjects. Peak and area-under-the-curve (AUC) insulin (P<.001) and AUC glucose (P<.05) responses to OGTT were also significantly higher in the FDRs than in control subjects. The FDRs showed higher insulinogenic index than the control subjects (P<.001). The FDRs had significantly (P<.05) higher LH and DHEAS levels and lower (P<.005) 17-OHP levels than the control subjects. Peak (P<.05) and AUC (P<.01) LH responses to buserelin testing were lower in the FDRs than in the control subjects while peak (P<.05) and AUC (P<.01) E₂ responses to buserelin were higher in the FDRs than in the control subjects.

Conclusion(s)

These data support the hypothesis that FDRs of PCOS patients may have insulin resistance and the HPG axis is more susceptible than in control subjects. The FDRs also have an increased prevalence of hyperandrogenism and high DHEAS levels compared with the background population.

Key Words: Glucose intolerance, first-degree relative, PCOS