Περίληψη:
OBJECTIVE Although a defect in GH regulation has been suggested in women
with polycystic ovarian syndrome (PCOS), the data are limited and
mechanism obscure. We have assessed the function of the GH/IGF-I axis in
women with PCOS by measuring basal IGF-I levels and the ability of the
pituitary to secrete GH following dopamine and GHRH.
DESIGN For each woman the complete study lasted 3 days. On the 1st and
2nd days, saline (0.9%, 5 ml/h for 3 h) and dopamine (4 mu g/kg/min for
3 h) infusion tests were performed, respectively, in all FOGS and
control women. Blood samples for GH measurement were obtained before and
at 20-minute intervals for 3 hours. On the 3rd day a GHRH test (100 mu
g, i.v.bolus) was performed in 9 of the women with PCOS and in 9
controls. Blood samples for GH measurements were obtained before and at
all-minute intervals for 3 hours. Basal IGF-I levels were measured in
the basal blood samples from the saline infusion test in all patients
studied.
SUBJECTS Thirteen women with PCOS and 11 normally menstruating women
(control group), aged 18-35 years, were studied. All women with PCOS had
hirsutism and oligomenorrhoea since menarche, elevated serum values of
at least one ovarian androgen and the typical ultrasound appearances of
PCOS.
RESULTS Growth hormone releasing hormone (GHRH) induced a significant
increase in GH secretion in both control and PCOS groups. However, the
GH response to GHRH was found to be significantly lower in women with
PCOS. The 3-hour infusion of dopamine induced a significant increase in
GH levels only in the control group, while it failed to stimulate GH
release in the women with PCOS. Although both dopamine and GHRH failed
to induce a normal GH response in women with PCOS, their IGF-I levels
did not differ significantly from those observed in control women.
CONCLUSIONS The diminished GH responses to both GHRH and dopamine in
women with PCOS, in the presence of normal circulating IGF-I levels,
suggests a dysregulation in GH secretion. Although the data are
suggestive of a hypothalamic defect, further studies are required to
clarify the underlying mechanism and the role, if any, of GH in the
pathogenesis of polycyctic ovarian syndrome.
Συγγραφείς:
PIADITIS, GP
KOUNADI, TG
RANGOU, DB
TROVAS, GP
KAKLAS,
NA
TZONOU, AJ
CHIOUVERAKIS, CS
