Effect of troglitazone on endocrine and ovulatory performance in women with insulin resistance-related polycystic ovary syndrome.
OBJECTIVE
To investigate the effect of troglitazone, a new antidiabetic agent that improves insulin resistance, on endocrine, metabolic, and ovulatory performance in women with insulin resistance-related polycystic ovary syndrome (PCOS).


METHODS
Prospective clinical study.


METHODS
Infertility outpatient clinic, Niigata University Hospital, Niigata, Japan.


METHODS
Thirteen women with PCOS and insulin resistance.


METHODS
Troglitazone (400 mg/d) was administered for 12 weeks.


METHODS
Insulin and other hormone (gonadotropins, androgens) levels; various parameters relating to glucose and lipid metabolism before, during, and after troglitazone administration; and ovulation rate.


RESULTS
The mean (+/-SD) fasting insulin concentration was significantly reduced, from 18.3+/-8.9 to 10.5+/-7.1 microU/mL. The LH level was reduced from 9.7+/-3.4 to 4.8+/-3.9 mIU/mL and the testosterone level was reduced from 0.9+/-0.5 to 0.5+/-0.3 ng/mL in accordance. Atherosclerotic lipid levels also were normalized. Before troglitazone administration, the ovulation rate during clomiphene citrate therapy was 34.9% per cycle (15/43). This increased significantly to 72.7% (8/11) during troglitazone coadministration. Further, an ovulation rate of 42.3% (11/26) was achieved with troglitazone alone.


CONCLUSIONS
In women with PCOS and insulin resistance, the reduction of hyperinsulinemia that is produced by troglitazone improves the hyperandrogenism that characterizes PCOS, restoring ovulation.
Hasegawa
I
I
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Japan.
Murakawa
H
H
Suzuki
M
M
Yamamoto
Y
Y
Kurabayashi
T
T
Tanaka
K
K
D000328:Adult; D000728:Androgens / Q000378:metabolism; D002839:Chromans / Q000627:therapeutic use*; D005260:Female; D006062:Gonadotropins / Q000378:metabolism; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D010060:Ovulation / Q000187:drug effects*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D013844:Thiazoles / Q000627:therapeutic use*; D045162:Thiazolidinediones; D000077288:Troglitazone