Fasting GLP-1 Levels in Women with PCOS and CAH

Abstract Background Polycystic ovarian syndrome (PCOS) is the most prevalent condition associated with increased androgens, but some rare diseases, e.g., congenital adrenal hyperplasia (CAH), should also be considered in the differential diagnosis of hyperandrogenemia. The potential role of incretin hormones has been thoroughly studied in different metabolic conditions, but data about women with PCOS and CAH are insufficient. Aims Therefore, the present study aims to investigate the fasting GLP-1 levels in women with PCOS and CAH compared to healthy women and to establish the possible associations with the ovarian and adrenal androgens, obesity, and hyperinsulinemia in these conditions. Methods Fasting GLP-1 levels were measured in 47 women with PCOS, 11 CAH patients, and 26 healthy volunteers. The associations between the GLP-1, metabolic, and hormonal characteristics in the investigated groups have been studied. Results GLP-1 levels did not differ between healthy women and patients with PCOS but were significantly higher in CAH patients (p = 0.025). CAH patients were similarly obese as PCOS women, but they showed increased testosterone (p = 0.009), 11-ketotestosterone (p = 0.046), 17-OH-progesterone (p < 0.001), and insulin levels (p = 0.043), and lower luteinizing hormone (p = 0.002) and dehydroepiandrosterone-sulfate levels (p = 0.004). In the PCOS group, the fasting GLP-1 levels were positively related to BMI (r = +0.327; p = 0.024) but not to other hormonal or metabolic indices. Conclusions Our results show increased fasting GLP-1 and insulin levels in CAH individuals compared with PCOS patients but similar fasting GLP-1 levels in PCOS and healthy women. Further studies are necessary to clarify the incretin effects and the role of incretin-based therapy in women with different hyperandrogenic states and increased metabolic risk.