Investigation of adrenal functions in patients with idiopathic hyperandrogenemia

Objective: Some patients with hyperandrogenemia had no identifiable cause, which was named as idiopathic hyperandrogenemia (IHA). The role of the adrenal glands in these patients was investigated. Design: Clinical study in patients with IHA at the Endocrinology Department of a University Hospital. Patient(s): In this study, 26 pre-menopausal women with IHA and 20 healthy women were included. Basal hormonal investigations, ACTH test and a 75 g oral glucose tolerance test (OGTT) were performed. Basal levels of total testosterone, free testosterone, androstenedione (A(4)), sex hormone-binding globulin, DHEA sulfate (DHEAS), cortisol, 17-hydroxyprogesterone (17-OHP), 11-deoxycortisol (11-S) and ACTH-stimulated levels of cortisol, A4, DHEAS, 17-OHP, and 11-S were measured. Additionally, glucose and insulin responses to OGTT were obtained. Results: The patients and the control subjects had similar age and body mass index. Peak and area under the curve (AUC) responses of 11-S (P < 0.05), DHEAS (P < 0.005), and A4 (peak, P < 0.005; AUC, P < 0.001) to ACTH test were significantly higher in the patients with IHA than in the control subjects. There was a significant correlation between the basal DHEAS levels, peak 11-S, and AUC(11-s), in response to ACTH-stimulation test in patients with IHA (P < 0.005, r, 0.6). Four (16.6%) patients with IHA had glucose intolerance. Conclusion: Our data suggest that adrenal androgen excess may play an important role in patients with IHA and these patients exhibit increased prevalence of glucose intolerance.