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Journal of Clinical Endocrinology & Metabolism Vol. 68, No. 6 1027-1032
doi:10.1210/jcem-68-6-1027
Copyright © 1989 by the Endocrine Society.
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Suppression of Serum Insulin by Diazoxide Reduces Serum Testosterone Levels in Obese Women with Polycystic Ovary Syndrome*

JOHN E. NESTLER, CORNELIUS O. BARLASCINI, DENNIS W. MATT, KENNETH A. STEINGOLD, STEPHEN R. PLYMATE, JOHN N. CLORE and WILLIAM G. BLACKARD

Departments of Internal Medicine (J.E.N., C.O.B., J.N.C., W.G.B.) and Obstetrics and Gynecology (D.W.M., K.A.S.), Medical College of Virginia/Virginia Commonwealth University Richmond, Virginia 23298
The Department of Clinical Investigation, Madigan Army Medical Center (S.R.P.) Tacoma, Washington 98431

Address all correspondence and requests for reprints to: John E. Nestler, M.D., Division of Endocrinology and Metabolism, Medical College of Virginia, MCV Station, Box 111, Richmond, Virginia 23298.

To test the hypothesis that insulin plays a role in the hyperandrogenism of obese women with polycystic ovary syndrome, we conducted a prospective study in which the androgen status of five obese women with polycystic ovary syndrome was assessed on two occasions: before and after 10 days of oral diazoxide (100 mg, three times daily) administration. Fasting serum insulin levels decreased from 177 ± 45 (±SE) to 123 ± 43 pmol±L (P < 0.01) and insulin release in response to 100 g oral glucose administration decreased from 223.0 ± 29.2 to 55.6 ± 7.9 nmol·min±L (P < 0.002) after diazoxide administration. At the same time, serum total testosterone fell from 2.5 ± 0.4 to 2.1 ± 0.3 nmol±L (P < 0.007), serum testosterone not bound to sex hormone-binding globulin fell from 1.9 ± 0.3 to 1.4 ± 0.2 nmol± L (P < 0.01), and the molar ratio of serum androstenedione to serum estrone fell from 25.7 ± 7.7 to 16.6 ± 5.5 (P < 0.04). Serum sex hormone-binding globulin levels increased slightly but not significantly from 13.2 ± 1.0 to 21.7 ± 4.1 nmol±L. Serum androstenedione, dehydroepiandrosterone sulfate, estradiol, estrone, and progesterone concentrations did not change, nor did basal or GnRH-stimulated serum LH and FSH concentrations. These results suggest that hyperinsulinemia in obese women with polycystic ovary syndrome may directly increase serum testosterone levels.

* Presented in part at the 1988 meeting of The Endocrine Society, New Orleans, LA. This work was supported in part by NIH Grants DK-18903 and RR-00065 and a Feasibility Grant from the American Diabetes Association.

Received November 21, 1988.




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