Diagnosis of polycystic ovary disease in obese women with a 24-hour hormone profile after buserelin stimulation

OBJECTIVE: To evaluate the 24-hour hormone response to GnRH agonist stimulation in the diagnosis of polycystic ovary disease (PCOD) in obese women. STUDY DESIGN: Forty-three obese PCOD patients and 23 controls were randomized to 1 mg buserelin (BSRL) stimulation (PCOD group P-1, n = 31; control group C-1, n = 12) or 0.1 mg (PCOD group P-0.1, n = 12; control group C-0.1, n = 11). RESULTS: Whereas following 1 mg BSRL administration, serum levels of 17 hydroxyprogesterone (17OHP), Δ ₄ androstenedione, estradiol (E ₂) and luteinizing hormone increment (ΔLH) as well as the ΔLH/Δfollicle stimulating hormone ratio were all higher in group P-1 than in group C-1 (P < .001, < .01, < .01, = .08 and < .001, respectively), only 170HP and E ₂ serum levels were higher in group P-0.1 than in group C-0.1 (P <.001, and = .01, respectively). Whereas 24-hour LH inversely correlated with body mass index (r = .37, P = .04), 24-hour hormone profile, and basal or glucose-stimulated serum insulin levels did not correlate in group P-1. CONCLUSION: The 1-mg BSRL stimulation test is a convenient diagnostic means in obesity-associated PCOD. The hormone response to BSRL administration is related to obesity, not to insulin resistance.