Intravenous lipid and heparin infusion-induced elevation in free fatty acids and triglycerides modifies circulating androgen levels in women: a randomized, controlled trial.

Description

Polycystic ovarian syndrome (PCOS) is one of the most frequent endocrinological disorders in women and is characterized by hyperandrogenism. Insulin resistance has been suggested to be a significant contributor to the elevated androgen levels in these women. However, other studies have reported that elevated free fatty acid (FFA) and triglyceride levels might be associated with increased androgen levels, independent of insulin concentrations. This study by Mai et al. sought to evaluate the effects of a short-term induced increase in FFA and triglycerides on androgen metabolism in a randomized, controlled crossover trial performed in a sample of 12 healthy young women. Intravenous lipid and heparin infusion increased androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), testosterone, 5a;-testosterone, estrone, and 17β-estradiol. Moreover, reductions in urinary excretion of DHEA, DHEAS, 5-androstene-3β;, 17β-diol, and the sum of urinary excreted DHEA and its 16-hydroxylated downstream metabolites, 16β-hydroxyDHEA and 5-androstene-3β, 16a, 17β-diol were observed. The study showed that increases in FFA and triglycerides due to lipid and heparin infusion significantly increased adrenal androgen precursors and circulating androgens by lowering their urinary excretion in vivo in healthy young women. These observations suggest that the relationship between fat metabolism and androgens could be involved in the development of hyperandrogenism in women with PCOS.