<b>Effect of insulin on serum levels of dehydroepiandrosterone metabolites in men</b>

Lavallée, Bernard; Provost, Pierre R.; Kahwash, Ziad; Nestler, John E.; Bélanger, Alain

doi:10.1046/j.1365-2265.1997.d01-1736.x

Cited by 30 publications

(20 citation statements)

References 43 publications

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“…On the other hand, Nestler et al reported a progressive decreasement in serum DHEAS levels in women during a hyperinsulinemic-euglycemic clamp study. They found the same decrement in the androstenedione levels too [27][28][29][30]. Various mechanisms of insulin-induced reduction of serum levels of adrenal androgens can be considered.…”

Section: Discussionmentioning

confidence: 79%

Assessment of Insulin Resistance in the Idiopathic Hirsutism

Saraç¹,

Saygılı²,

Ozgen³

et al. 2006

Gynecol Obstet Invest

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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.

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Section: Discussionmentioning

confidence: 79%

Assessment of Insulin Resistance in the Idiopathic Hirsutism

Saraç¹,

Saygılı²,

Ozgen³

et al. 2006

Gynecol Obstet Invest

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“…Rather, data suggest that hyperinsulinemia enhances the metabolic clearance of DHEAS, and that this mechanism might be responsible for the rapid decrease of DHEAS [17]. In fact, other studies that investigated the alteration of DHEAS under reactive physiological hyperinsulinemia could not demonstrate such a great decrease in DHEAS as those carried out under supraphysiological hyperinsulinemia [15,16].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Physiologic Hyperinsulinemia during an Oral Glucose Tolerance Test on the Levels of Dehydroepiandrosterone (DHEA) and Its Sulfate (DHEAS) in Healthy Young Adults Born with Low and with Normal Birth Weight

Vásárhelyi¹,

Bencsik

Treszl

et al. 2003

Endocr J

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Abstract. Several data support that adrenal hyperandrogenism affects women with low birth weight (LBW). We also found an association between serum dehydroepiandrosterone (DHEA) and fasting insulin levels. The aim of our study was to detect the acute effects of reactive hyperinsulinemia during oral glucose tolerance test (OGTT) on DHEA(S) levels in LBW men and women. Fifty three men and 47 women (of those, 37 men and 33 women were LBW) were enrolled. DHEA, DHEAS, and insulin levels were measured before and during OGTT. Cortisol was also measured. DHEA/cortisol ratio during OGTT was calculated to analyze the acute effect of hyperinsulinemia on DHEA levels. During OGTT, DHEA and cortisol levels decreased in each individual, independently of gender and birth weight. Serum DHEAS decreased to a minor (but significant) extent only in LBW women (p<0.05). The rate of DHEA/cortisol increased in both gender, independently of birth weight. The increase of the rate of DHEA/cortisol during OGTT was associated with maximal insulin response (r = 0.45, p<0.05) and with the insulin AUC (r = 0.48, p<0.05) in women. Our results suggest that reactive hyperinsulinemia during OGTT might activate the androgen pathway of adrenal cortex including DHEA production. Therefore acute hyperinsulinemia might counterbalance to some extent the diurnal decrease of DHEA during OGTT.

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“…In this regard, it has been proposed that reduced DHEA may mediate the relationship with an increased risk of cardiovascular disease through a diminished inhibition of fibroblast growth and differentiation, alterations in the plasma lipid profile and through a diminished inhibition of platelet aggregation (88). It has also been shown that insulin may increase the metabolic clearance of DHEA (89), and studies by our group have demonstrated that hyperinsulinemia induced during DHEA infusion stimulated DHEA fatty acid esterification through the action of plasma lecithin: cholesterol acyltrasferase (90). On the other hand, DHEA-S may have direct effects on insulin sensitivity by increasing insulin binding to its own receptor (91).…”

Section: Insulin Resistance and Hyperinsulinemiamentioning

confidence: 93%

Dehydroepiandrosterone, obesity and cardiovascular disease risk: a review of human studies

Tchernof

Labrie

2004

European Journal of Endocrinology

152

100

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The age-related decline in serum dehydroepiandrosterone (DHEA) and its sulfated ester (DHEA-S) has suggested that a relative deficiency of these steroids may be causally related to the development of chronic diseases generally associated with aging, including insulin resistance, obesity, cardiovascular disease, cancer, reductions of the immune defense, depression and a general deterioration in the sensation of well-being. The numerous studies which have focused on the link between DHEA and cardiovascular disease have generally been inconsistent, generating much debate and controversy on this issue. The present article is an analysis of studies on the relationship between endogenous DHEA or DHEA-S, obesity and cardiovascular disease risk, as well as DHEA treatment studies. Elevated plasma levels of free DHEA are associated with reduced obesity in both men and women, and with smaller abdominal body fat accumulations in men. However, contradictory results have been reported regarding the relationships between the sulfate ester DHEA-S and adiposity. Age differences in the populations studied may have been a confounding factor in these associations. On the other hand, DHEA-S level is not a predictor of cardiovascular disease endpoints in women, and appears to be a relatively weak one in men. DHEA intervention studies suggest that the effects of DHEA on serum lipids are, at best, modest or non-significant. The uncertainty as to whether endogenous and exogenous DHEA should be considered cardioprotective is related to discrepancies in the literature on this topic. Several studies may have been plagued by methodological problems such as low power, unreliable analytical methods, confounding factors or other differences in the populations studied. As a consequence, the original reports demonstrating dramatic effects of either endogenous or exogenous DHEA on cardiovascular disease risk have never been replicated. We propose that the effects of DHEA on cardiovascular disease risk (either favorable or unfavorable) should be considered to be much more modest than previously believed.

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Effect of insulin on serum levels of dehydroepiandrosterone metabolites in men

Abstract: These results suggest that insulin increases the DHEA metabolic clearance rate by stimulating its conversion to DHEA-FA and by enhancing uptake of DHEA-FA by peripheral tissues.

Cited by 30 publications

References 43 publications

Assessment of Insulin Resistance in the Idiopathic Hirsutism

Assessment of Insulin Resistance in the Idiopathic Hirsutism

The Effect of Physiologic Hyperinsulinemia during an Oral Glucose Tolerance Test on the Levels of Dehydroepiandrosterone (DHEA) and Its Sulfate (DHEAS) in Healthy Young Adults Born with Low and with Normal Birth Weight

Dehydroepiandrosterone, obesity and cardiovascular disease risk: a review of human studies

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