Objective: To evaluate what hormonal or biochemical parameters are most highly associated with the finding of polycystic-appearing ovaries as compared with normal-appearing ovaries in women with polycystic ovary syndrome (PCOS).
Design: Prospective randomized study.
Setting: Academic medical center.
Patients: Ten women with PCOS-five with normal-appearing ovaries and five with polycystic-appearing ovaries-were matched for age and body mass index. All had serum T levels between 80 and 150 ng/dL (conversion factor to SI unit, 3.467).
Intervention(s): Insulin infusion for the purpose of performing insulin tolerance testing to evaluate insulin resistance or sensitivity.
Main outcome measure(s): We measured serum T, DHEAS, androstenedione, sex-hormone binding globulin, 5 alpha-androstane-3 alpha-17 beta-androstenediol glucuronide, FSH, LH, insulin-like growth factor-I, insulin-like growth factor binding protein-1, and insulin-like growth factor binding protein-3. Insulin resistance, measured by insulin tolerance testing, also was done on the same day after the patient had fasted for at least 8 hours.
Result(s): Serum androgens and binding proteins were not significantly different in both groups. Insulin tolerance testing demonstrated a slower glucose disappearance in the polycystic appearing ovary group (Kitt glucose was 4.58% +/- 1.4%/min in the normal-appearing ovaries group versus 2.07% +/- 1.07%/min in the polycystic-appearing ovaries group).
Conclusion(s): Women with PCOS and polycystic-appearing ovaries do not demonstrate any definitive serum hormonal differences compared with women with PCOS and normal-appearing ovaries. The presence of polycystic-appearing ovaries correlates significantly with the presence of insulin resistance.