Hi!

I’ve seen some articles that state that the FSH:LH ratio is raised in women with CAH. While several papers state that women with CAH (as well as carriers of the mutation) have an increased risk of PCOS, as far as I’ve seen no one has come up with a concrete reason why PCOS occurs. Got lots of theories floating around out there tho.

As for insulin resistance in NCCAH, I found this little abstract:

The study was designed to investigate the influence of androgens on peripheral glucose metabolism in women with congenital adrenal hyperplasia (CAH). Nine normal women and seven women with CAH were studied (4 with the classical form of 21-hydroxylase deficiency [C 21-OH] and 3 with nonclassical 21-hydroxylase deficiency [NC 21-OH]). The study was performed using the forearm model combined with local indirect calorimetry. The insulin level reached 30 minutes after glucose ingestion was significantly greater (p < .05) in patients with CAH. The patients with C 21-OH had elevated androstenedione (A) and testosterone (T) and low DHEA-S and presented a 35% greater insulin response to a glucose stimulus than the control group, area under the curve (AUC) of 9457+/-887 vs 6989+/-833 mu U/ml . 3 hours. Patients with NC 21-OH had slightly elevated T, A and DHEA-S and presented an insulin response that was similar to the control group, AUC = 7208+/- 1935 mu U/ml . 3 hours. Despite the greater muscle mass of the patients with CAH the forearm glucose uptake during the three hours of the study was lower in these patients than in normal women (CAH = 100.9+/-10.0 vs control group = 132.5+/-21.2 mg/100 ml forearm). The ratio of insulin response to the increment of forearm glucose uptake over a period of 3 h was significantly higher in patients with CAH (control group = 59.6+/-6.5 vs CAH = 98.6+/-19.4 mu U . ml(-1)/ mg . 100 ml forearm(-1), p < 0.05). These results suggest that insulin sensitivity is decreased in patients with CAH. The impairment is greater in patients with elevated Delta 4 androgens (A and T) and low serum DHEA-S levels.

Authors Paula F J. Other Authors Gouveia L M; Paccola G M; Piccinato C E; Moreira A C; Foss M C. Publication Hormone And Metabolic Research | vol 26 no 11 | pp.552-556 | Nov 94

Hope this helps!

Liz