Effect of pioglitazone on glucose metabolism and luteinizing hormone secretion in women with polycystic ovary syndrome.

Abstract

OBJECTIVE:

To thoroughly examine the mechanisms for insulin resistance in polycystic ovary syndrome (PCOS) and to evaluate the effects of pioglitazone treatment on insulin resistance, beta-cell function, LH secretion, and glucose metabolism.

DESIGN:

Randomized, blinded, placebo-controlled study.

SETTING:

Outpatient clinic, at a university hospital in Denmark.

PATIENT(S):

Thirty obese women with PCOS and 14 weight-matched healthy females.

INTERVENTION(S):

Sixteen weeks of blinded treatment with pioglitazone (30 mg/d) or placebo.

MAIN OUTCOME MEASURE(S):

Fasting blood samples, 24-hour 20-minute integrated blood sampling (LH, insulin, and C-peptide), euglycemic hyperinsulinemic clamps including 3-(3)H glucose, and indirect calorimetry were performed before and after the intervention period.

RESULT(S):

Patients with PCOS had significantly lower insulin sensitivity compared with controls, including significantly decreased insulin-stimulated oxidative and nonoxidative glucose metabolism. Pioglitazone treatment resulted in significantly lower levels of fasting insulin and significantly higher insulin sensitivity, increased insulin-stimulated glucose oxidation, and increased insulin-stimulated inhibition of lipid oxidation. During 24-hour blood sampling, significantly lower area under-the-curve insulin and lower median insulin levels were observed. Secretion profiles of LH and E(2) and T levels did not change significantly.

CONCLUSION(S):

Insulin resistance in PCOS was characterized by hyperinsulinemia, impaired insulin-stimulated oxidative and nonoxidative glucose metabolism, which was partly reversed by pioglitazone treatment.

• Authors: Dorte Glintborg, Anne Pernille Hermann, Marianne Andersen, Claus Hagen, Henning Beck-Nielsen, Johannes D Veldhuis, Jan Erik Henriksen
• Journal: Fertility and sterility (Fertil Steril) Vol. 86 Issue 2 Pg. 385-97 (Aug 2006) ISSN: 1556-5653 [Electronic] United States
• PMID: 16782094 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Hormones
• Hypoglycemic Agents
• Insulin
• Thiazolidinediones
• Luteinizing Hormone
• Pioglitazone

Topics

• Adult
• Blood Glucose (metabolism)
• Double-Blind Method
• Fasting (blood)
• Female
• Glucose Clamp Technique
• Hormones (blood)
• Humans
• Hyperinsulinism (etiology)
• Hypoglycemic Agents (therapeutic use)
• Insulin (metabolism, pharmacology)
• Insulin Resistance
• Insulin Secretion
• Insulin-Secreting Cells (drug effects, metabolism)
• Luteinizing Hormone (metabolism)
• Menstrual Cycle (drug effects)
• Oxidation-Reduction
• Pioglitazone
• Polycystic Ovary Syndrome (complications, drug therapy, metabolism, physiopathology)
• Thiazolidinediones (therapeutic use)