Ethinylestradiol/cyproterone acetate in polycystic ovary syndrome: lipid and carbohydrate changes.
OBJECTIVE
Ethinylestradiol (EE) combined with the antiandrogenic progestin cyproterone acetate (CPA) is a possible treatment in polycystic ovary syndrome (PCOS). We investigated the impact of EE/CPA on lipid and carbohydrate metabolism in women with PCOS,who were otherwise healthy.


METHODS
The 31 women were separated into two groups paired by body mass index (BMI): Group A (control, n = 15) were cycled with 10 mg medroxyprogesterone acetate (MPA) x 10 days (Provera, Pharmacia & Upjohn) every month for 3 months; Group B (n = 16) were treated with 35 microg EE/2 mg CPA (Diane 35, Schering) for 3 months. Metabolic and hormonal conditions were similar in both groups.


RESULTS
Group A showed no change in any hormone or metabolic parameter. Group B showed a significant decrease in free androgen index (-81%) and increase in sex hormone binding globulin (+ 639%), a decrease in low density lipoprotein cholesterol (-14%) and total cholesterol/high density lipoprotein (HDL) cholesterol index (-19%), and increases in HDL cholesterol (+ 23%) and triglycerides (+ 82%) (p < 0.001). Fasting insulin increased in 18%, the glucose/insulin index worsened in 8%, and the plasma glucose disappearance worsened in 12%, with no statistical significance (p= 0.092, p=0.308 and p= 0.237, respectively).


CONCLUSIONS
Treatment of PCOS with EE/CPA induces important favorable changes regarding hormone parameters associated with hyperandrogenism, significant favorable changes in lipid profile except for triglyceride increase, and no significant change in carbohydrate metabolism (measured by fasting insulin, glucose/insulin index and plasma glucose disappearance). MPA cycling does not change any of these parameters.
Villaseca
P
P
Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Hormaza
P
P
Cárdenas
I
I
Oestreicher
E
E
Arteaga
E
E
D000284:Administration, Oral; D000328:Adult; D000728:Androgens / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D017373:Cyproterone Acetate / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000187:drug effects; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D000728:Androgens; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D002784:Cholesterol