Vanky E, Salvesen K A, Carlsen S M
Department of Obstetrics and Gynecology, St Olavs Hospital, University Hospital of Trondheim, Norway.
Hum Reprod. 2004 Mar;19(3):529-33. doi: 10.1093/humrep/deh103. Epub 2004 Jan 29.
The purpose of this study was to investigate the effect of low-dose dexamethasone on androgen levels in women with polycystic ovary syndrome (PCOS) treated with diet and lifestyle counselling, and metformin.
A prospective, randomized, double blind, placebo-controlled study was carried out. Thirty-eight women with PCOS were randomized to either dexamethasone 0.25 mg daily or placebo for 26 weeks. All received diet and lifestyle counselling at inclusion and metformin 850 mg three times daily during the whole study. Main outcome measures were: androgen levels, body mass index (BMI), insulin c-peptide, fasting glucose and serum lipids. Two-tailed t-tests and Pearson's statistics were used.
Compared with the placebo, dexamethasone reduced testosterone by 27%, androstenedione by 21%, dehydroepiandrosterone sulphate by 46% and free testosterone index by 50% in women with PCOS treated with diet and lifestyle advice, and metformin. BMI, fasting glucose, insulin c-peptide and serum lipid levels were unaffected.
Six-month, low-dose dexamethasone treatment further reduces androgen levels in metformin-treated PCOS women.
本研究旨在探讨低剂量地塞米松对接受饮食和生活方式咨询及二甲双胍治疗的多囊卵巢综合征（PCOS）女性雄激素水平的影响。
开展了一项前瞻性、随机、双盲、安慰剂对照研究。38名PCOS女性被随机分为每日服用0.25毫克地塞米松组或安慰剂组，为期26周。所有参与者在纳入研究时均接受饮食和生活方式咨询，且在整个研究过程中每日三次服用850毫克二甲双胍。主要观察指标为：雄激素水平、体重指数（BMI）、胰岛素C肽、空腹血糖和血脂。采用双尾t检验和Pearson统计方法。
在接受饮食和生活方式建议及二甲双胍治疗的PCOS女性中，与安慰剂相比，地塞米松使睾酮降低了27%，雄烯二酮降低了21%，硫酸脱氢表雄酮降低了46%，游离睾酮指数降低了50%。BMI、空腹血糖、胰岛素C肽和血脂水平未受影响。
为期六个月的低剂量地塞米松治疗可进一步降低接受二甲双胍治疗的PCOS女性的雄激素水平。
