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Hyperinsulinemia and Stromal Luteinization of the Ovaries in Postmenopausal Women With Endometrial Cancer^*

Departments of Obstetrics and Gynecology and Medicine, University of Texas Medical Branch Galveston, Texas 77550

Address requests for reprints to: Manubai Nagamani, M.D., Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77550.

Ovarian secretion of testosterone and androstenedione is increased in postmenopausal women with endometrial cancer, and insulin stimulates ovarian stromal androgen synthesis in vitro. We undertook this study to investigate whether women with endometrial cancer have increased serum immunoreactive insulin levels. Ten postmenopausal women with endometrial carcinoma and 10 postmenopausal women without cancer who matched the cancer patients in age, years since menopause, and percentage of ideal body weight were studied. The women with endometrial cancer had significantly higher fasting serum insulin levels than the normal women [mean, 187 ± 26 (±SE) vs. 55 ± 11 pmol/L; P < 0.01]. The cancer patients had significantly higher insulin responses after glucose administration than normal women (sum of 1, 2, and 3 h postglucose values, 5545 ± 1526 vs. 1444 ± 156 pmol/L; P < 0.02), even though their glucose responses were similar. Nests of luteinized cells, which were positive for testosterone by immunoperoxidase staining, were found in the ovarian stroma of 8 of the women with endometrial cancer, but in only 1 of those without cancer (P < 0.01). Specific high affinity insulin receptors were demonstrable in the stroma of the postmenopausal ovaries. These results suggest that the frequency of stromal luteinization is increased in women with endometrial cancer and that insulin may play a role in the pathogenesis of this luteinization.

^* Presented in part at the 35th Annual Meeting of the Society for Gynecologic Investigation, Atlanta, GA, March 1987. This work was supported in part by Grant RR-73 from the General Clinical Research Centers Program of the Division of Research Resources, NIH.

Received November 19, 1987.

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