Efficacy of octreotide-LAR in dieting women with abdominal obesity and polycystic ovary syndrome.
BACKGROUND
Somatostatin reduces LH, GH, and insulin, and somatostatin receptors are present at the ovarian level; somatostatin analogs are thus potential candidates for treatment of the polycystic ovary syndrome (PCOS).


OBJECTIVE
The purpose of this study was to evaluate the effect of octreotide-LAR, a long-acting somatostatin analog, in anovulatory abdominal obese women with PCOS.


METHODS
A single-blind, placebo-controlled study was performed, lasting for 7 months.


METHODS
The patients were ambulatory throughout the study.


METHODS
Twenty PCOS subjects were enrolled. Eighteen completed the study.


METHODS
A low-calorie diet was given during the first month, a low-calorie diet plus octreotide-LAR (10 mg; n = 10 subjects) or placebo (n = 10 subjects) was then given, with one im injection every 28 d (for 6 months).


METHODS
The main outcome measures were clinical features, computerized tomography measurement of fat distribution, androgens, GH, IGF-I, IGF-binding proteins (IGFBPs), fasting and glucose-stimulated insulin, and ovulation.


RESULTS
Octreotide had no additional effect in reducing body fat or improving fat distribution than placebo. Conversely, octreotide produced an additional decrease in fasting (P = 0.018) and glucose-stimulated (P = 0.038) insulin levels, an increase in IGFBP-2 (P = 0.042) and IGFBP-3 (P = 0.047), and an improvement in hirsutism (P = 0.004). Moreover, a trend toward greater reductions in testosterone (P = 0.061) and androstenedione (P = 0.069) was observed in women treated with octreotide-LAR compared with those given placebo. All women treated with octreotide ovulated at the end of the study compared with only one of those receiving placebo (P < 0.001).


CONCLUSIONS
Octreotide-LAR may be usefully applied to hypocalorically dieting, abdominal obese PCOS women to improve hyperandrogenism and the insulin-IGF-I system. Restoration of ovulatory menstrual cycles appears to be another advantage of this treatment.
Gambineri
Alessandra
A
Division of Endocrinology, Department of Internal Medicine, Center for Applied Biomedical Research, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy.
Patton
Laura
L
De Iasio
Rosaria
R
Cantelli
Barbara
B
Cognini
Graciela Estela
GE
Filicori
Marco
M
Barreca
Antonina
A
Diamanti-Kandarakis
Evanthia
E
Pagotto
Uberto
U
Pasquali
Renato
R
D000328:Adult; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D008598:Menstruation; D009765:Obesity / Q000178:diet therapy* / Q000503:physiopathology; D015282:Octreotide / Q000008:administration & dosage*; D010060:Ovulation; D010349:Patient Compliance; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D016037:Single-Blind Method
D007986:Luteinizing Hormone; D015282:Octreotide