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Effect of obesity on the response to acute adrenocorticotropin stimulation in eumenorrheic women.
Fertil Steril. 1991 Sep; 56(3):427-33.FS

Abstract

OBJECTIVE

Alterations in adrenocortical biosynthesis, as measured by the steroid response to acute adrenocorticotropic hormone (ACTH) stimulation, have frequently been reported in female hyperandrogenism. These patients are also commonly obese, which may account for some of these abnormalities. The object of this study was to test the hypothesis that obesity alters the adrenal response to acute adrenal stimulation.

DESIGN

A prospective study of healthy premenopausal women of varying weights.

SETTING

University-based clinical research center.

PATIENTS

Fifty-seven healthy, eumenorrheic, nonhirsute female volunteers were studied, 30 weighing between 90% and 110% (normal-weight) and 27 weighing greater than 120% (obese) their ideal body weight.

INTERVENTIONS

All subjects underwent a 60-minute acute intravenous ACTH-(1-24) stimulation test in the follicular phase (days 3 to 8) of the menstrual cycle.

MAIN OUTCOME MEASURES

The basal levels of dehydroepiandrosterone sulfate (DHEAS), total and free testosterone (T), sex hormone-binding globulin (SHBG), estrone, estradiol, prolactin, and the luteinizing and follicle-stimulating hormone ratio were measured. Basal and poststimulation levels of androstenedione (A), dehydroepiandrosterone (DHEA), 17 alpha-hydroxyprogesterone (17 alpha-OHP), 17-hydroxypregnenolone (17-PREG), 11-deoxycortisol (S), and cortisol (F) were also obtained, and the net increments after stimulation were calculated.

RESULTS

Normal-weight and obese women did not differ in age, height, or waist-hip ratio. Obese volunteers demonstrated lower circulating SHBG, 17-PREG, and S levels, and S/F ratio, but a higher free T and DHEAS/DHEA levels. No other differences were observed in either basal or adrenal response measures, with the exception of the net increment in A, which was almost twofold higher in obese volunteers (P less than 0.001).

CONCLUSIONS

Obesity in eumenorrheic nonhirsute women is associated with lower circulating SHBG activity and higher free T and DHEAS/DHEA levels. No significant difference in adrenocortical response to acute ACTH-(1-24) stimulation was observed between obese and normal-weight women, with the exception of a higher net adrenal output of A. It does not appear that the abnormal adrenal stimulation results frequently observed in hyperandrogenic women are a consequence of their obesity.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Alabama, Birmingham 35294.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1894020

Citation

Azziz, R, et al. "Effect of Obesity On the Response to Acute Adrenocorticotropin Stimulation in Eumenorrheic Women." Fertility and Sterility, vol. 56, no. 3, 1991, pp. 427-33.
Azziz R, Zacur HA, Parker CR, et al. Effect of obesity on the response to acute adrenocorticotropin stimulation in eumenorrheic women. Fertil Steril. 1991;56(3):427-33.
Azziz, R., Zacur, H. A., Parker, C. R., Bradley, E. L., & Boots, L. R. (1991). Effect of obesity on the response to acute adrenocorticotropin stimulation in eumenorrheic women. Fertility and Sterility, 56(3), 427-33.
Azziz R, et al. Effect of Obesity On the Response to Acute Adrenocorticotropin Stimulation in Eumenorrheic Women. Fertil Steril. 1991;56(3):427-33. PubMed PMID: 1894020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of obesity on the response to acute adrenocorticotropin stimulation in eumenorrheic women. AU - Azziz,R, AU - Zacur,H A, AU - Parker,C R,Jr AU - Bradley,E L,Jr AU - Boots,L R, PY - 1991/9/11/pubmed PY - 2001/3/28/medline PY - 1991/9/11/entrez SP - 427 EP - 33 JF - Fertility and sterility JO - Fertil Steril VL - 56 IS - 3 N2 - OBJECTIVE: Alterations in adrenocortical biosynthesis, as measured by the steroid response to acute adrenocorticotropic hormone (ACTH) stimulation, have frequently been reported in female hyperandrogenism. These patients are also commonly obese, which may account for some of these abnormalities. The object of this study was to test the hypothesis that obesity alters the adrenal response to acute adrenal stimulation. DESIGN: A prospective study of healthy premenopausal women of varying weights. SETTING: University-based clinical research center. PATIENTS: Fifty-seven healthy, eumenorrheic, nonhirsute female volunteers were studied, 30 weighing between 90% and 110% (normal-weight) and 27 weighing greater than 120% (obese) their ideal body weight. INTERVENTIONS: All subjects underwent a 60-minute acute intravenous ACTH-(1-24) stimulation test in the follicular phase (days 3 to 8) of the menstrual cycle. MAIN OUTCOME MEASURES: The basal levels of dehydroepiandrosterone sulfate (DHEAS), total and free testosterone (T), sex hormone-binding globulin (SHBG), estrone, estradiol, prolactin, and the luteinizing and follicle-stimulating hormone ratio were measured. Basal and poststimulation levels of androstenedione (A), dehydroepiandrosterone (DHEA), 17 alpha-hydroxyprogesterone (17 alpha-OHP), 17-hydroxypregnenolone (17-PREG), 11-deoxycortisol (S), and cortisol (F) were also obtained, and the net increments after stimulation were calculated. RESULTS: Normal-weight and obese women did not differ in age, height, or waist-hip ratio. Obese volunteers demonstrated lower circulating SHBG, 17-PREG, and S levels, and S/F ratio, but a higher free T and DHEAS/DHEA levels. No other differences were observed in either basal or adrenal response measures, with the exception of the net increment in A, which was almost twofold higher in obese volunteers (P less than 0.001). CONCLUSIONS: Obesity in eumenorrheic nonhirsute women is associated with lower circulating SHBG activity and higher free T and DHEAS/DHEA levels. No significant difference in adrenocortical response to acute ACTH-(1-24) stimulation was observed between obese and normal-weight women, with the exception of a higher net adrenal output of A. It does not appear that the abnormal adrenal stimulation results frequently observed in hyperandrogenic women are a consequence of their obesity. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/1894020/Effect_of_obesity_on_the_response_to_acute_adrenocorticotropin_stimulation_in_eumenorrheic_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(16)54535-X DB - PRIME DP - Unbound Medicine ER -