Spironolactone in the treatment of polycystic ovary syndrome: effects on clinical features, insulin sensitivity and lipid profile

• Published in: Journal of endocrinological investigation Vol. 28; no. 1; pp. 49 - 53
• Main Authors: Zulian, E, Sartorato, P, Benedini, S, Baro, G, Armanini, D, Mantero, F, Scaroni, C
• Format: Journal Article
• Language: English
• Published: Italy 01.01.2005
• Subjects: Adolescent; Adult; Androgen Antagonists - therapeutic use; Area Under Curve; Body Mass Index; Caloric Restriction; Diet; Female; Glucose Tolerance Test; Humans; Insulin - blood; Insulin Resistance - physiology; Lipids - blood; Obesity - complications; Obesity - therapy; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - drug therapy; Polycystic Ovary Syndrome - physiopathology; Spironolactone - therapeutic use
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/bf03345529

This prospective clinical trial was designed to assess the effects of a long-term therapy with spironolactone, with and without dietary-induced weight-loss, on clinical features, lipid profile and insulin levels in women with polycystic ovary syndrome (PCOS). Twenty-five patients (range of age 16-32 yr; 13 lean and 12 overweight) fulfilling formal diagnostic criteria for PCOS (oligomenorrhea and/or amenorrhea, biochemical and/or clinical evidence of hyperadrogenism) were studied at baseline and then received oral spironolactone (100 mg/die) for 12 months; association with lifestyle modifications was recommended to all over-weight patients. Clinical, endocrine and metabolic parameters [oral glucose tolerance test (OGTT), lipid profile] were measured at baseline and at the end of the antiandrogen treatment. The therapy was associated with a significant average decline of triglycerides in overweight subjects and with increased HDL-cholesterol levels in lean patients. The insulin levels at 60 min during OGTT, homeostasis model assessment-insulin resistance and area under curve of insulin were significantly lowered in overweight women after 12 months of spironolactone and weight loss and no negative changes in insulin secretion and sensitivity were observed in PCOS women after pharmacological treatment alone. The efficacy of spironolactone on the androgenic clinical aspects of PCOS has been confirmed in this study. Furthermore, our data show that long-term treatment with spironolactone exerts no negative effects on lipoprotein profile and glucose metabolism; more relevant beneficial effects on glucose and lipid metabolism were observed when the antiandrogen was associated with weight loss in overweight PCOS women.