Metabolic and ovarian effects of rosiglitazone treatment for 12 weeks in insulin-resistant women with polycystic ovary syndrome.
BACKGROUND
Insulin sensitizers have favourable metabolic and ovarian effects in polycystic ovary syndrome (PCOS). This study examined rosiglitazone, a thiazolidinedione, in PCOS.


METHODS
In a prospective, open-label study, the effects of rosiglitazone on metabolism and ovarian function were examined in 42 non-diabetic women with PCOS classified according to the National Institute of Child Health and Human Development criteria and insulin resistance (IR) by steady-state plasma glucose (SSPG) > or =10 mmol/l on octreotide-modified insulin suppression testing. Participants were randomized to rosiglitazone 2, 4 or 8 mg daily for 12 weeks. Endpoints included ovulation and menstrual pattern; serum testosterone, sex hormone-binding globulin (SHBG), and LH; and changes in IR and glucose-insulin responses on 8 h mixed-meal profile.


RESULTS
After rosiglitazone 8 mg daily for 12 weeks, SSPG declined and insulinaemia fell by 46%; lower doses gave lesser effects. Serum LH, total and free testosterone were unchanged; SHBG increased. With rosiglitazone, ovulation occurred in 23/42 women (55%), without significant dose dependence. Both before and during treatment, ovulators on rosiglitazone had lower circulating insulin and free testosterone and higher SHBG than non-ovulators. Testosterone declined only in a subgroup of ovulators with early vaginal bleeding after starting rosiglitazone.


CONCLUSIONS
Rosiglitazone in insulin-resistant PCOS promoted ovulation and dose-dependently decreased IR and insulinaemia; ovulators had lower circulating insulin and testosterone.
Cataldo
Nicholas A
NA
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. nixie54@yahoo.com
Abbasi
Fahim
F
McLaughlin
Tracey L
TL
Basina
Marina
M
Fechner
Patricia Y
PY
Giudice
Linda C
LC
Reaven
Gerald M
GM
D001786:Blood Glucose / Q000187:drug effects; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D008598:Menstruation; D010053:Ovary / Q000187:drug effects; D010060:Ovulation / Q000187:drug effects*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D000077154:Rosiglitazone; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D045162:Thiazolidinediones / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014621:Vagina / Q000473:pathology
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D013739:Testosterone; D007986:Luteinizing Hormone