JOHN E. NESTLER, M.D.
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To the editor: To Dr. Braunstein's (1) list of causes for the menstrual abnormalities seen in some women with growth-hormone-secreting pituitary tumors, I propose an additional possible mechanism: insulin-like growth factor I (IGF-I) stimulation of androgen production. Although Lim and Dingman (2) have previously shown adrenal androgenic hyperfunction in acromegaly, they proposed that growth hormone induced an enzymatic block that shunted corticosteroid precursors into androgenic biosynthetic pathways. Recent evidence indicates that in vitro both insulin and IGF-I have a stimulatory effect on various steroidogenic steps, including lipoprotein uptake and metabolism (3) and P450 cholesterol side-chain cleavage enzyme levels (4). Extending
NESTLER JE. Stimulation of Androgen Production by Insulin-like Growth Factor I. Ann Intern Med. 1986;105:796. doi: 10.7326/0003-4819-105-5-796_1
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Published: Ann Intern Med. 1986;105(5):796.
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