Hum. Reprod. Advance Access originally published online on February 24, 2006
Human Reproduction 2006 21(6):1400-1407; doi:10.1093/humrep/dei505
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Endocrine and metabolic effects of rosiglitazone in overweight women with PCOS: a randomized placebo-controlled study
1 Department of Obstetrics and Gynaecology and 2 Department of Clinical Chemistry, Oulu University Hospital, Oulu, Finland
3 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Oulu University Hospital, P.O. Box 5000, FIN-90014 Oulu, Finland. E-mail: juha.tapanainen{at}oulu.fi
BACKGROUND: The objective of the study was to assess the therapeutic effects of rosiglitazone in overweight women with polycystic ovary syndrome (PCOS). METHODS: A double-blind, placebo-controlled study was conducted on 30 (BMI > 25 kg/m2, mean age 29.1 ± 1.2 years) overweight women with PCOS treated with rosiglitazone or placebo for 4 months. Waist-to-hip ratios (WHRs), serum concentrations of sex hormones and binding proteins, blood glucose, serum insulin and serum C-peptide during a 75-g oral glucose tolerance test (OGTT), first-phase insulin secretion as determined by an intravenous glucose tolerance test (IVGTT), M values (expressing insulin sensitivity using a euglycaemic clamp) and calorimetric data were assessed at 0 and 4 months of treatment. RESULTS: Rosiglitazone improved menstrual cyclicity, increased serum sex hormone-binding globulin (SHBG) levels and decreased serum levels of androstenedione, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEA-S). Glucose tolerance [expressed as AUCglucose during the OGTT] improved (P = 0.002) and peripheral insulin response (expressed as AUCinsulin) decreased (P = 0.004) in the rosiglitazone group (ROSI group). M value improved in the ROSI group from 33.4 ± 3.27 to 40.0 ± 5.51 µmol/kg min (P = 0.04). CONCLUSION: Rosiglitazone, by improving menstrual cyclicity, hyperandrogenism, insulin resistance and hyperinsulinaemia, represents an alternative treatment for overweight anovulatory women with PCOS and no pregnancy desire.
Key words: insulin resistance/PCOS/rosiglitazone
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