Disparate effects of pharmacotherapy on plasma plasminogen activator inhibitor-1 levels in women with the polycystic ovary syndrome.

Abstract

OBJECTIVE:

Polycystic ovary syndrome (PCOS) is characterized by obesity and insulin resistance (IR), which result in elevated plasminogen activator inhibitor-1 (PAI-1) levels. We aimed to assess the changes in PAI-1 levels in PCOS during treatment with metformin and during weight loss.

DESIGN:

Twenty-three normal weight women with PCOS were given metformin 850 mg bid for 6 months. Fifty overweight/obese women with PCOS were prescribed an energy-restricted diet, were instructed to exercise and were randomized to orlistat 120 mg tid or sibutramine 10 mg qd for 6 months.

RESULTS:

In normal weight women, treatment with metformin reduced the body mass index (BMI) and circulating androgens, improved markers of IR and lowered PAI-1 levels. In overweight/obese women, sibutramine and orlistat yielded comparable reductions in BMI and markers of IR. In contrast, the effects on the free androgen index (FAI) differed (p=0.027): sibutramine reduced the FAI (p=0.005), whereas orlistat had no effect. The effects of sibutramine and orlistat on PAI-1 levels also differed (p=0.042): sibutramine reduced PAI-1 levels (p<0.001), whereas orlistat had no effect.

CONCLUSIONS:

Metformin and sibutramine, but not orlistat, reduce PAI-1 levels in PCOS. The reduction in circulating androgens during metformin and sibutramine treatment might be implicated in this decline.

• Authors: Ekaterini Koiou, Konstantinos Tziomalos, Ilias Katsikis, Dimitrios Delkos, Elena A Tsourdi, Dimitrios Panidis
• Journal: Hormones (Athens, Greece) (Hormones (Athens)) 2013 Oct-Dec Vol. 12 Issue 4 Pg. 559-66 ISSN: 2520-8721 [Electronic] Switzerland
• PMID: 24457404 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Androgens
• Anti-Obesity Agents
• Cyclobutanes
• Hypoglycemic Agents
• Lactones
• Plasminogen Activator Inhibitor 1
• Metformin
• Orlistat
• sibutramine

Topics

• Adolescent
• Adult
• Androgens (blood)
• Anti-Obesity Agents (pharmacology, therapeutic use)
• Comorbidity
• Cyclobutanes (pharmacology, therapeutic use)
• Diet, Reducing
• Drug Therapy
• Exercise
• Female
• Humans
• Hypoglycemic Agents (pharmacology, therapeutic use)
• Lactones (pharmacology, therapeutic use)
• Metformin (pharmacology, therapeutic use)
• Obesity (blood, drug therapy, epidemiology)
• Orlistat
• Overweight (blood, drug therapy, epidemiology)
• Plasminogen Activator Inhibitor 1 (blood)
• Polycystic Ovary Syndrome (blood, drug therapy, epidemiology)
• Treatment Outcome
• Young Adult