Human Reproduction, Vol. 16, No. 10, 2066-2072,
October 2001
© 2001 European Society of Human Reproduction and Embryology
Clinical, endocrine and metabolic effects of acarbose, an 
-glucosidase inhibitor, in PCOS patients with increased insulin response and normal glucose tolerance
1 Department of Microbiological and Gynaecological Sciences, 2 Division of Endocrinology, Department of Internal Medicine, University of Catania, Catania and 3 Department of Obstetrics and Gynecology, University of Siena, Siena, Italy
BACKGROUND: The aim of this study was to evaluate whether treatment with acarbose, an 
-glucosidase inhibitor, improved hyperandrogenic symptoms, insulin and androgen serum concentrations in hyperinsulinaemic patients with polycystic ovary syndrome (PCOS). METHODS: 30 hyperinsulinaemic women with PCOS and 15 controls were evaluated. Patients were randomized, using a computer-generated randomization list, into two groups of 15 each and treated with placebo or 300 mg/day of acarbose for three months. Hirsutism and acne/seborrhoea scores, hormonal and sex hormone binding globulin serum concentrations, glycaemia and insulin responses to a standard oral glucose load (75g) were measured in all patients before and after three months of treatment. RESULTS: A significant reduction of the acne/seborrhoea score was observed in patients treated with acarbose and eight of them resumed a regular menstrual rhythm. These clinical improvements were associated with a significant reduction of the insulin response to glucose load, a significant decrease of LH, total testosterone and androstenedione and with a significant increase of sex hormone binding globulin serum concentrations. The serum concentrations of FSH, dehydroepiandrosterone sulphate, prolactin and 17-hydroxyprogesterone did not change significantly. No clinical, metabolic and hormonal modifications were observed in PCOS patients treated with placebo. CONCLUSIONS: This is the first report showing a reduction of the acne/seborrhoea score in hyperinsulinaemic patients with PCOS treated with acarbose. This improvement was associated with a significant decrease of the insulin response to oral glucose load and of LH and androgen serum concentrations and with a significant rise of sex hormone binding globulin concentration.
Key words: acarbose/hyperinsulinaemia/hypoglycaemizing drugs/polycystic ovary syndrome
4 To whom correspondence should be addressed at: Department of Microbiological and Gynaecological Sciences, University of Catania, Ospedale Santo Bambino, Via Torre del Vescovo, 95124 Catania, Italy. E-mail: marcofarina{at}supereva.it
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