Hyperinsulinemia and circulating dehydroepiandrosterone sulfate in white and Mexican American women with polycystic ovary syndrome.

OBJECTIVE: To determine whether Mexican American women with polycystic ovary syndrome (PCOS), a population more insulin resistant than white women with PCOS, demonstrate differences in adrenal androgen production.
DESIGN: Retrospective study.
SETTING: University gynecology clinic and research laboratory. PATIENT(S): One hundred eleven white women and 50 Mexican American women with PCOS based on the 2003 Rotterdam Consensus Statement. INTERVENTION(S): Blood sampling, oral glucose tolerance testing, and ultrasonography. MAIN OUTCOME MEASURE(S): Serum total T, free T, DHEAS, and calculation of multiple insulin sensitivity indices after an oral glucose challenge. RESULT(S): Mexican American women with PCOS were significantly more insulin resistant than their white counterparts but had lower circulating levels of DHEAS, a reliable index of adrenal androgen production. Age and body mass index (BMI) were each inversely proportional to serum DHEAS, but no association was found between circulating insulin and serum DHEAS levels. Testosterone levels were similar between groups. CONCLUSION(S): The lower levels of DHEAS observed in the more insulin resistant Mexican American group with PCOS (compared to a similar group of white women living in the same locale) further corroborates the extent of phenotypic variability among specific PCOS populations. Hyperinsulinemia does not appear to significantly influence circulating adrenal androgen levels in PCOS.