Involvement of ovarian steroids in the opioid-mediated reduction of insulin secretion in hyperinsulinemic patients with polycystic ovary syndrome.
To evaluate the possible involvement of ovarian steroids on the opioid-mediated disorders of insulin in patients affected by polycystic ovary syndrome (PCOS), we studied 40 PCOS women. All patients underwent an oral glucose tolerance test (OGTT; 75 g) and basal hormone assay; based on the insulin response to OGTT, 26 women were classified as hyperinsulinemic and continued the study protocol. Patients were randomly divided into three groups characterized by different treatments: group A (nine patients) was treated with GnRH analog (one ampule every 28 days for 2 months), group B (eight patients) was treated with naltrexone (an oral opioid antagonist, 50 mg/day, orally) for 8 weeks, and group C (nine patients) was treated with GnRH analog plus naltrexone for 2 months. After continuation of treatment, all patients repeated the basal study in a second hospitalization. Naltrexone treatment significantly reduced the insulin response to OGTT, whereas GnRH analogue administration did not significantly change the insulin secretion after the glucose load. The GnRH analog/ naltrexone cotreatment was not able to influence the insulin secretory pattern; in fact, the insulin area under the curve was superimposable before and after therapy. These data could lead to the hypothesis that the opioidergic regulation of insulin secretion requires a normal steroidogenic pattern, thus suggesting that ovarian steroids modulate opioid activity also at peripheric districts.
Guido
M
M
Institute of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy.
Pavone
V
V
Ciampelli
M
M
Murgia
F
F
Fulghesu
A M
AM
Apa
R
R
Caruso
A
A
Mancuso
S
S
Lanzone
A
A
D000328:Adult; D000728:Androgens / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000503:physiopathology*; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D007700:Kinetics; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000097:blood; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D018847:Opioid Peptides / Q000502:physiology*; D010053:Ovary / Q000503:physiopathology*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D013256:Steroids / Q000502:physiology*
D000728:Androgens; D007328:Insulin; D009292:Narcotic Antagonists; D018847:Opioid Peptides; D013256:Steroids; D004958:Estradiol; D009271:Naltrexone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide