Effects of the Insulin Sensitizer Pioglitazone on Menstrual Irregularity, Insulin Resistance and Hyperandrogenism in Young Women with Polycystic Ovary Syndrome

• Published in: Journal of pediatric & adolescent gynecology Vol. 27; no. 3; pp. 177 - 182
• Main Authors: Stabile, Gaspare, PhD, Borrielli, Irene, Artenisio, Alfredo Carducci, MD, Bruno, Lucia Maria, Benvenga, Salvatore, MD, Giunta, Loretta, MD, La Marca, Antonio, MD, Volpe, Annibale, MD, Pizzo, Alfonsa, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2014
• Subjects: Adiponectin; Adiponectin - blood; Adolescent; C-Reactive Protein - metabolism; Female; Fibrinogen - metabolism; Hirsutism - drug therapy; Humans; Hyperandrogenism - drug therapy; Hypoglycemic Agents - therapeutic use; Insulin Resistance; Insulin resistence; Luteinizing Hormone - blood; Menstrual Cycle - drug effects; Menstruation Disturbances - drug therapy; Obstetrics and Gynecology; Pediatrics; Pioglitazone; Polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - drug therapy; Thiazolidinediones - therapeutic use; Young Adult; Polycystic ovary syndrome; Insulin resistence; Pioglitazone; Adiponectin
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2013.09.015

Abstract Background Polycystic ovary syndrome (PCOS) is the most common endocrine cause of menstrual irregularities, hirsutism and acne. Women with PCOS present elevated plasma insulin levels, both fasting and after a glucose load, as an indirect evidence of insulin resistance. PCOS women may also present hypertension, low levels of HDL cholesterol, hypertriglyceridemia, visceral obesity and a higher level of CRP and fibrinogen that can predict an atherosclerotic risk. Methods This study was carried out on 15 young women with PCOS selected according to the 2003 diagnostic criteria of The Rotterdam Consensus Statement and 15 Control women. PCOS women were treated with pioglitazone 30 mg/day and at the beginning and after 6 months of treatment were evaluated: menstrual cycle trend, hirsutism and acne, total cholesterolemia and HDL, triglyceridemia, fibrinogenemia, C-reactive protein, oral glucose tolerance test, glycated hemoglobin, FSH, LH, 17OH-progesterone, 17β-estradiol, free and total testosterone, SHBG, DHEA-S, Δ4-androstenedione and adiponectin. Results and Discussion Treatment with pioglitazone improves the irregularities of menses and hirsutism. Six months of treatment modify other parameters linked with a higher risk of type 2 diabetes mellitus and cardiovascular diseases: adiponectin increased with reduction of insulin resistance while fibrinogen and CRP levels decreased.