Effect on insulin sensitivity of Implanon vs. GnRH agonist in women with endometriosis.
OBJECTIVE
To evaluate the influence of two medical treatments for endometriosis on insulin sensitivity.


METHODS
After surgery, 26 women with endometriosis were randomly allocated to a 6-month treatment with a GnRH agonist (Leuprorelin 3.75 mg/28 days) or a subdermal progestin implant (etonogestrel 68 mg). Insulin sensitivity (SI) and glucose utilization independent of insulin (Sg) were investigated at baseline and after 6 months by a frequently sampled intravenous glucose tolerance test (FSIGT) associated with the minimal model method.


RESULTS
Both therapies tended to decrease SI, but the effect did not reach statistical significance in the GnRH agonist group (5.43+/-1.29 vs. 3.99+/-0.8) and was significant in the etonogestrel group (5.74+/-1.12 vs. 3.95+/-0,78; p=.046). Sg, fasting glucose, insulin, C-peptide and C-peptide/insulin were not modified by either treatment.


CONCLUSIONS
The modifications of glucose-insulin metabolism induced by the GnRH agonist are of no relevance for the short-term use of this molecule. Even if the modification induced by the etonogestrel implant is subtle and of no major impact, it should be taken into consideration for the long-term treatment of individuals with abnormalities of glucose-insulin metabolism.
Cagnacci
Angelo
A
Department of Obstetrics, Gynaecology and Pediatrics Sciences, University of Modena, 41100 Modena, Italy. cagnacci@unimore.it
Tirelli
Alessandra
A
Cannoletta
Marianna
M
Pirillo
Debora
D
Volpe
Annibale
A
D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D017135:Desogestrel / Q000009:adverse effects*; D004343:Drug Implants; D004715:Endometriosis / Q000188:drug therapy* / Q000601:surgery; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016729:Leuprolide / Q000009:adverse effects*
D001786:Blood Glucose; D002096:C-Peptide; D004343:Drug Implants; D007328:Insulin; C044815:etonogestrel; D017135:Desogestrel; D016729:Leuprolide