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Adrenocortical hyperresponsiveness to corticotropin in polycystic ovary syndrome patients with adrenal androgen excess

Adrenocortical hyperresponsiveness to corticotropin in polycystic ovary syndrome patients with adrenal androgen excess,10.1016/j.fertnstert.2003.07.00

Adrenocortical hyperresponsiveness to corticotropin in polycystic ovary syndrome patients with adrenal androgen excess   (Citations: 18)
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ObjectiveTo test the hypothesis that adrenal androgen (AA) excess in the polycystic ovary syndrome (PCOS) is due to a generalized exaggeration in AA output in response to adrenocorticotropic hormone (ACTH), and that this abnormality is due to an identifiable alteration in the biosynthesis of AAs.
Journal: Fertility and Sterility - FERT STERIL , vol. 81, no. 1, pp. 126-131, 2004
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    • ... and on the presence of keratinization of the vaginal wall epithelium, the main characteristic of persistent estrus, and also based on the presence of polycystic ovaries observed during histological examination at autopsy. The body weights of the androgenized animals and of the controls were 250 and 202 g, respectively, and this difference was statistically significant (p < 0.0001). The animals were sacrificed, and their adrenal glands were located and removed, fixed in 10% formol for 24 h, and processed and stained with hematoxylin and eosin for light microscopy. Only one adrenal gland from each animal was used for the study. The morphological study primarily characterized the architecture of the three layers of the adrenal cortex: the zona glomerulosa, the zona fasciculata, and the zona reticularis. For the morphometric analysis, a trinocular Zeiss microscope with a ×10 objective (magnification ×100) was used, connected to a color video camera that transmitted the image to a microcomputer. A digital image analysis software program was used to measure the thickness of the adrenal cortex zones in micrometers. Four sections were examined in each animal. The thickness of the adrenal cortex was obtained by measuring the distance between the medulla and the adrenal capsule in a straight line, one measurement being taken in each quadrant of the adrenal cortex. Comparative statistical analysis of the measurements of the variables G (zona glomerulosa), F (zona fasciculata) and R (zona reticularis) was carried out in both groups using Student’s t test for two independent samples, followed by Levene’s test for the comparison of differences between the two groups. Differences were considered statistically significant when p < 0.05.Results Macroscopically, the adrenal glands of the androgenized rats were larger and darker in color than those of the animals in the control group. Light microscopy showed the adrenal glands of the control group to be covered with a capsule of dense conjunctive tissue, under which the adrenal cortex zones could be seen: the zona glomerulosa containing cells with basophilic cytoplasm, the zona fasciculata with cords of cells in parallel bundles reaching towards the medulla, and, between the zona fasciculata and the medulla, the zona reticularis which is rich in blood vessels. Although the adrenal glands of the androgenized animals had a general architecture similar to that of the control group, they were considerably more voluminous and had a much thicker and intensely vascularized zona reticularis than those of the animals in the control group (fig. 1, 2). Analysis of the morphometric data revealed a significant increase in the mean thickness of the zona reticularis in group II (730.71 vs. 328.37 μm in the control group; p < 0.001). The mean thickness of the zona glomerulosa of the animals in group II was 58.42 μm which was also significantly greater as compared with the control group with a mean thickness of 45.00 μm (p < 0.011). There was no statistically significant difference in the mean thickness of the zona fasciculata between the two groups of animals (p = 0.294; table 1).Discussion The etiology of the excessive adrenal androgen production in women with PCOS is unknown. One of the possibilities is that the increase in adrenal androgens in PCOS may be the result of abnormalities of the adrenocortical steroidogenesis as a consequence of the exaggerated production of these hormones in response to stimulation by adrenocorticotropic hormone [...

    Benedito Borges da Silvaet al. Morphological and Morphometric Analysis of the Adrenal Cortex of Andro...

    • ...In fact, the single steroidogenic difference that we were able to observe between PCOS women and healthy controls was a greater estimated ' 5 17-D -hydroxylase (17-OH) activity, primarily observed in PCOS patients with high DHEAS levels (52)...

    Bulent O. Yildizet al. Hypothalamic-Pituitary-Adrenal Dysfunction in the Polycystic Ovary Syn...

    • ...patients with supranormal DHEAS levels (49)...

    Wendy Y. Changet al. Pathogenesis of Hyperandrogenism in Polycystic Ovary Syndrome

    • ...Adrenal androgen excess appears therefore to be due to adrenocortical steroidogenic abnormalities, abnormalities in the metabolism of adrenal products or to alterations in the responsivity of adrenals to ACTH as women with PCOS present a generalized hypersecretion of adrenocotrical products in response to ACTH stimulation [20]...

    Neoklis A. Georgopouloset al. Hyperandrogenism in PCOS

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