Clinical, endocrine and metabolic effects of acarbose, an alpha-glucosidase inhibitor, in PCOS patients with increased insulin response and normal glucose tolerance.
BACKGROUND
The aim of this study was to evaluate whether treatment with acarbose, an alpha-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 17alpha-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.
Ciotta
L
L
Department of Microbiological and Gynaecological Sciences, University of Catania, Ospedale Santo Bambino, Via Torre del Vescovo, 95124 Catania, Italy.
Calogero
A E
AE
Farina
M
M
De Leo
V
V
La Marca
A
A
Cianci
A
A
D020909:Acarbose / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D004702:Endocrine Glands / Q000187:drug effects*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005947:Glucose / Q000502:physiology; D005951:Glucose Tolerance Test; D005959:Glucosidases / Q000037:antagonists & inhibitors*; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000503:physiopathology; D007328:Insulin / Q000502:physiology*; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D012016:Reference Values; D016896:Treatment Outcome
D000728:Androgens; D004791:Enzyme Inhibitors; D007328:Insulin; D007986:Luteinizing Hormone; D005959:Glucosidases; D005947:Glucose; D020909:Acarbose