Role of growth hormone in polycystic ovarian syndrome.

Given recent in-vitro and in-vivo evidence that insulin and growth hormone may have gonadotropin-augmenting effects, the putative endocrine role of serum growth hormone levels in women with polycystic ovarian syndrome (PCOS) has been investigated in several studies since 1990. Obesity is a disease entity in its own right and, therefore, a confounding influence on investigations of PCOS. PCOS in the absence of obesity may be viewed as the "authentic syndrome". The use of IGF-1 as a marker of growth hormone secretion is not fully adequate as there is little to no correlation between this peptide and growth hormone in women with PCOS. The development of hyposomatotropinism in obese PCOS women appears to be an obesity-dependent event. The confirmed observation in both obese and lean women with and without PCOS of serum IGF-1 and IGFBP-3 levels requires further delineation. Preliminary evidence suggest that GH may play a role in the lean woman with PCOS and that the presence of obesity dampens its effect. Future investigations of the role of growth hormone in PCOS are dependent on first elucidating the role of GH in adult women and in the disease state of obesity.