A pilot study of the long-term effects of acipimox in polycystic ovarian syndrome.
BACKGROUND
To evaluate the effects of long-term acipimox administration on glucose-induced insulin secretion and peripheral insulin sensitivity in polycystic ovarian syndrome (PCOS), 20 PCOS subjects (eight lean and 12 obese) and 14 body mass index-matched controls (seven lean and seven obese) were investigated.


METHODS
Fasting blood samples were collected for basal hormone and lipoprotein assays, after which patients underwent an oral glucose tolerance test (OGTT). The following day a euglycaemic-hyperinsulinaemic clamp was performed. After 4-6 weeks of treatment with acipimox at a dose of 250 mg given orally three times a day, the patients repeated the study protocol.


RESULTS
No significant differences were found in the glucose, insulin or C-peptide responses to OGTT before and after anti-lipolytic drug administration in any group, nor was there any effect on insulin sensitivity. Concerning the lipid profile, acipimox administration led to a significant decrease of cholesterol and low-density lipoprotein levels in obese PCOS patients as well as in obese and lean controls. Lower triglycerides were found after the drug administration in both obese groups. Post-treatment free fatty acid levels were not significantly different when compared with basal values.


CONCLUSIONS
Acipimox does not appear to be an effective insulin-lowering drug in PCOS, even if it can be used in obese women with PCOS as an additional therapeutic agent to ameliorate the atherogenic lipid profile of the syndrome.
Ciampelli
M
M
Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, Rome 00168, Italy.
Leoni
F
F
Lattanzi
F
F
Guido
M
M
Apa
R
R
Lanzone
A
A
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D009765:Obesity / Q000097:blood / Q000150:complications / Q000188:drug therapy; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011719:Pyrazines / Q000627:therapeutic use*; D013851:Thinness; D013997:Time Factors; D014280:Triglycerides / Q000037:antagonists & inhibitors / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D000960:Hypolipidemic Agents; D007328:Insulin; D011719:Pyrazines; D014280:Triglycerides; C027696:acipimox