Assessment of Insulin Resistance in the Idiopathic Hirsutism

Abstract

Background: Idiopathic hirsutism (IH) is the second most common cause of hirsutism, after polycystic ovary syndrome and occurs in about 15% of hirsute women. There are not many studies showing whether patients with IH also have insulin resistance. In the present study, we aimed to investigate the insulin sensivity in IH with non-obese and changing hormone levels during the hyperinsulinemic-euglycemic clamp. Methods: Twenty (20) non-obese women with IH (Group I) ranging in age from 20 to 30 (mean 25 ± 5) years were studied. Hirsutism in women with normal testosterone (T) levels and regular menstrual cycles is as defined IH. Twenty (20) healthy women (mean age 23 ± 2 years) (Group II) were included in this study as the control group. Insulin sensitivity was assessed with modified euglycemic insulin clamp technique. Samples of prolactin, luteinizing hormone (LH), follicle-stimulating hormone, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulfate, cortisol, estradiol, progesterone, 17-OH progesterone (17-OHP), total T, and free T (FT) were obtained at baseline and at 2nd hour during clamp. Results: Steady-state (120 min) glucose disposal rates were higher in Group II than Group I (7.51 ± 0.83 vs. 5.76 ± 1.89 mg/kg/min). Mean FT, ACTH, cortisol, LH, prolactin and 17-OHP levels were found to have decreased statistically significantly (p < 0.05) in Group I. Mean FT, ACTH, and prolactin levels were found to have decreased statistically significantly (p < 0.05) in Group II during the clamp. Mean baseline levels of FT, LH and prolactin were greater in women with hirsutism than in the control subjects (p < 0.05). Insulin mediated glucose disposal was lower in the normal weight women with IH than in those without hirsutism. Conclusions: Mean FT, 17-OHP and dehydroepiandrosterone sulfate levels decreased during euglcemic-hyperinsulinemic clamp in IH.

The lack ofassociationbetween idiopathic hirsutism and metabolic disturbances: Iranian PCOS Prevalence Study

“…There is limited data from studies, with small sample size, on the association between IH and IR, and the results are controversial [17,20,33,34]. In contrast to our study, UnlÜ hizarci et al [33] reported a higher prevalence of impaired glucose tolerance in 32 patients with IH, in comparison to the normal controls, results similar to those of three studies conducted on 16, 20, and 31 women with IH [17,18,20]. Furthermore, Paoletti et al [19] documented that antiandrogen treatment improved hyper insulinemia in 11 women with IH.…”

“…Apart from the different diagnostic criteria for IH and IR used, these discrepancies could be attributed to genetic factors, lifestyle characteristics, and dietary habits. Furthermore, the recruitment methods of IH subjects and controls affects on the estimates of IR prevalence; however, subjects of the above mentioned studies were recruited from clinics [17,18,20], while our subjects were enrolled during a population-based study to minimize selection bias; variation in BMI or android obesity of study participants can partly explain the controversial findings of current studies [35].…”

“…It is not clear whether the peripheral increase of androgen activity in IH affects insulin metabolism [16][17][18] and, as a result, women with IH exhibit insulin resistance. There are limited number of studies with small sample size that report an increase in insulin resistance (IR) among women with IH [17,19,20]; however, the impact of IH on metabolic syndrome (MetS) has not been documented.…”

Higher Metabolic Risk with National Institutes of Health Versus Rotterdam Diagnostic Criteria for Polycystic Ovarian Syndrome in Turkish Women

“…In some previous studies, insulin resistance has been associated with idiopathic hirsutism in BMI-matched groups. [34][35][36] However, after researchers matched BMI values among subjects in another study, 37 the observed difference in insulin resistance between control subjects and women with idiopathic hirsutism disappeared. Frajndlich and colleagues recently linked insulin resistance to ovarian volume in patients with idiopathic hirsutism.…”

Evaluation of various insulin sensitivity indices in lean idiopathic hirsutism patients

“…Sarac et al [21] found that insulin mediated glucose disposal was lower in normal weight women with IH than healthy control subjects.…”