Insulin-like growth factors IGF-I and IGF-II are bound to specific binding proteins in serum. The lower mol. wt binding protein (IGF-BP) has been detected in various tissues, including secretory endometrium and preovulatory follicles of the ovary. This group studied the circulating levels of IGF-BP in the serum of 23 patients with polycystic ovarian disease (PCOD) and found that one-third of them have a subnormal level. In comparison with PCOD patients with a normal level, those with a subnormal level had a higher degree of obesity and a tendency to be more hirsute. They also had a higher serum insulin concentration and testosterone/sex hormone-binding globulin (SHBG) ratio, but lower serum SHBG concentration than those with a normal IGF-BP level. PCOD is the second abnormal clinical condition, after insulinoma, in which subnormal serum IGF-BP concentrations have been reported. The significance of low serum IGF-BP levels to pathophysiology of PCOD remains to be elucidated by studies on local interaction between IGF-BP and insulin in the polycystic ovary.

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Testosterone (T) concentrations in saliva and serum were measured in 53 women with various degrees of hirsutism and hyperandrogenism. The bioavailability of T was judged by comparing the correlations among the grade of hirsutism, salivary testosterone (SaT), and serum total and free T (fT) and sex hormone-binding globulin (SHBG) levels. The effect of body mass index on the correlations was also studied. The high SaT concentrations [mean, 237.6 +/- 66.7 (+/- SD) pmol/L] compared to the serum fT concentrations (mean, 29.1 +/- 11.8 pmol/L) in hirsute women may reflect the bioavailability of albumin-bound T or an ability of the salivary glands to metabolize steroids. SaT was more closely related to the T/SHBG ratio (mean, 82.5 X 10(-3) +/- 54.8), reflecting the non-SHBG-bound fraction of T, than to serum fT, which might support the former theory. SaT correlated better to the degree of hirsutism (rho = 0.45; P less than 0.01) than did any of the serum T parameters or SHBG. The correlation between SaT and hirsutism was partly dependent on the effect of body mass index. After eliminating this effect, SaT still correlated with hair growth on the total body area (rho = 0.36; P less than 0.05). On the basis of the results, SaT seems to relate to the bioavailable fraction of the hormone and, thus, appears to be an optimal method for studying hirsute women.