Brief report: impaired processing of prohormones associated with abnormalities of glucose homeostasis and adrenal function

Abnormal levels of insulin and adrenal hormones may lead to poor glucose regulation and be caused by an inability to process the precursors of various hormones. A 43-year-old woman had abnormally low blood sugar after eating, had been obese as a child, and only began ovulating after receiving gonadotropins. Although her insulin genes were normal, she had low levels of insulin in her blood, but high levels of insulin precursors. Similarly, she had low levels of cortisol and corticotropin, but high levels of the precursors of these hormones. She also had slightly low levels of sex hormones and certain thyroid hormones. These results suggest that she may have had a genetic abnormality that affected one or both of the prohormone convertase enzymes used to process hormone precursors.