OBJECTIVE: To evaluate the association between insulin/insulin-like growth factor I (IGF-I) systems and androgen levels in pregnancy. DESIGN: Prospective cohort study. SETTING: Yale University School of Medicine. PATIENT(S): Pregnant women undergoing a 100-gram 3-hour glucose tolerance test (GTT). INTERVENTION(S): Serum samples collected during GTT were analyzed for insulin, androgens, free IGF-I, insulin-like growth factor-binding protein (IGFBP) 1, and estriol. MAIN OUTCOME MEASURE(S): Observing the relationship between insulin/IGFs and androgen levels. RESULT(S): The insulin area under the curve (I(AUC)) during GTT correlated positively with total T and free T, but not with dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), or estriol. The peak insulin values (I(max)) during GTT also correlated positively with total T and free T, but not with DHEA, DHEAS, or estriol. There was no statistically significant correlation of T levels with free IGF-I, IGFBP-1, glucose, DHEAS, or estriol. Multiple linear regression analysis modeling showed that I(AUC) and I(max) did have a statistically significant correlation with free T levels. CONCLUSION(S): This study demonstrates for the first time that I(AUC) and I(max) measured in hyperinsulinemic states such as pregnancy correlate with T levels. In view of the lack of correlation between insulin and DHEAS or estriol, insulin-related T production during pregnancy is likely of ovarian origin.
OBJECTIVE: To evaluate the association between insulin/insulin-like growth factor I (IGF-I) systems and androgen levels in pregnancy. DESIGN: Prospective cohort study. SETTING: Yale University School of Medicine. PATIENT(S): Pregnant women undergoing a 100-gram 3-hour glucose tolerance test (GTT). INTERVENTION(S): Serum samples collected during GTT were analyzed for insulin, androgens, free IGF-I, insulin-like growth factor-binding protein (IGFBP) 1, and estriol. MAIN OUTCOME MEASURE(S): Observing the relationship between insulin/IGFs and androgen levels. RESULT(S): The insulin area under the curve (I(AUC)) during GTT correlated positively with total T and free T, but not with dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), or estriol. The peak insulin values (I(max)) during GTT also correlated positively with total T and free T, but not with DHEA, DHEAS, or estriol. There was no statistically significant correlation of T levels with free IGF-I, IGFBP-1, glucose, DHEAS, or estriol. Multiple linear regression analysis modeling showed that I(AUC) and I(max) did have a statistically significant correlation with free T levels. CONCLUSION(S): This study demonstrates for the first time that I(AUC) and I(max) measured in hyperinsulinemic states such as pregnancy correlate with T levels. In view of the lack of correlation between insulin and DHEAS or estriol, insulin-related T production during pregnancy is likely of ovarian origin.
Authors: K Sathishkumar; M Balakrishnan; V Chinnathambi; M Chauhan; G D V Hankins; C Yallampalli Journal: J Perinatol Date: 2011-09-08 Impact factor: 2.521