ACTA ENDOCRINOLOGICA (BUC)

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Context. Polycystic ovary syndrome (PCOS) or disease (PCOD) is one of the most common causes of female infertility. Objective. The objective of this study was to find out the influence of insulin on LH, testosterone and SHBG in diffrent PCOS categories. Experimental design. A total of 800 women who were subjected to infertility treatment at infertility clinics were selected. About 60 healthy females with regular menstrual cycles were considered as control. The data were collected from hospital records using subject’s consent. Results. Relationship of insulin to LH and testosterone was positive and significant (p<0.05) in the entire PCOS group and in five PCOS subcategories with increased LH rise (i.e. 1.3, 2, 3, 4 & 5 times of LH rise in relation to FSH levels in each group respectively). The correlation pattern showed an increasing trend from lower to increased rise of LH compared to FSH. The relationship between insulin and SHBG was negative and significant (p<0.05) in all PCOS subcategories, except for the group having similar LH and FSH levels and also in another group with FSH levels higher than LH levels. A strong positive correlation was established between insulin and SHBG in normal subjects. The percentage of negative correlation was strong in PCOD subcategories with elevated rises of LH. Conclusion. This study established the influence of insulin on other marker hormones (LH, testosterone an SHBG) in various PCOS categories in view of their percentage of relationship.

Cushing syndrome in the paediatric age group is very difficult to diagnose due to atypical presenting features in children. Primary pigmented nodular adrenocortical disease (PPNAD) is a rare cause of ACTH-independent Cushing syndrome in children and it has characteristic gross and microscopic pathologic features. We report a case of PPNAD in a 16-year-old boy who was evaluated in our hospital with chief complaints of poor height velocity and rapid weight gain for 2-3 years before presentation. Proper evaluation showed ACTH-independent Cushing syndrome with normal imaging. Total bilateral adrenalectomy was performed followed by hormones replacement. 6 months after surgery, significant acceleration of height velocity was noticed. Patient also lost body weight and developed secondary sexual characteristics.