Normalization of hyperinsulinemia by chronic opioid receptor blockade in hyperandrogenemic women.
OBJECTIVE
Evaluation of the effects of naltrexone on hyperinsulinemia and hyperandrogenemia in hyperandrogenemic, hyperinsulinemic women.


METHODS
Controlled clinical study.


METHODS
Department of Gynecologic Endocrinology and Reproductive Medicine, Center of Obstetrics and Gynecology, Medical University of Innsbruck, Austria.


METHODS
Thirty-nine hyperandrogenemic, hyperinsulinemic women were studied.


METHODS
Women were treated with naltrexone (50 mg/d) for >or=3 weeks.


METHODS
Body mass index (BMI), gonadotropin (LH, FSH) and androgen (T, free T, DHEAS) levels, and plasma levels of glucose, insulin, and C-peptide, during a standard 75-g oral glucose tolerance test (OGTT), were determined before and during chronic opiate receptor blockade.


RESULTS
The BMI did not change during therapy. When OGTT was repeated after treatment with naltrexone, glucose levels were not different from those before treatment. Insulin response, however, had dramatically declined. We also observed a significant decrease in the levels of serum androgens.


CONCLUSIONS
Hyperinsulinemia associated with hyperandrogenemia can be improved or completely abolished by chronic opiate receptor blockade. This observation suggests that endogenous opiates play a critical role in the process leading to hyperinsulinemia in hyperandrogenemia.
Hadziomerović
Dijana
D
Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria. dijanah@gmx.de
Rabenbauer
Bernhard
B
Wildt
Ludwig
L
D000328:Adult; D000728:Androgens / Q000097:blood; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006946:Hyperinsulinism / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007328:Insulin / Q000097:blood; D009271:Naltrexone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D016896:Treatment Outcome
D000728:Androgens; D007328:Insulin; D009292:Narcotic Antagonists; D009271:Naltrexone