Glintborg Dorte, Hermann Anne Pernille, Hagen Claus, Jensen Lars Thorbjørn, Frystyk Jan, Bennett Paul, Flyvbjerg Allan, Andersen Marianne
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
Fertil Steril. 2009 Mar;91(3):842-50. doi: 10.1016/j.fertnstert.2007.12.082. Epub 2008 Apr 9.
To investigate possible effects of insulin-sensitizing treatment on cortisol metabolism in insulin-resistant patients with polycystic ovary syndrome (PCOS).
Randomized placebo-controlled study.
Academic tertiary care medical center.
PATIENT(S): Thirty insulin-resistant PCOS patients.
INTERVENTION(S): Sixteen weeks of pioglitazone (30 mg/day) or placebo treatment.
MAIN OUTCOME MEASURE(S): Twenty-four-hour 20 min integrated blood sampling for measurement of cortisol and 24 h urinary excretion of steroid metabolites. Relative 5alpha-reductase activity was evaluated by allotetrahydrocortisol (alloTHF)/THF and androsterone/etiocholanolone (A/E) ratios. Delta values denoted changes during the treatment period (16 weeks--basal). Pyridostigmine growth hormone (GH) stimulation tests were performed, and testosterone (T), dihydrotestosterone (DHT), DHEA, DHEAS, adiponectin, and insulin-like growth factor I (IGF-I) were measured before and after intervention.
RESULT(S): Insulin sensitivity, GH, adiponectin, and IGF-I significantly increased during pioglitazone treatment, whereas alloTHF/THF levels significantly decreased. Delta alloTHF/THF levels inversely correlated with Delta adiponectin levels. Delta A/E ratio inversely correlated with Delta IGF-I and Delta peak GH during GH stimulation tests. No significant changes were measured in T, DHT, DHEA, DHEAS, 24 h mean cortisol, or urinary excretion of steroid metabolites.
CONCLUSION(S): Pioglitazone decreased relative 5alpha-reductase activity, whereas no significant changes were measured in cortisol levels or urinary cortisol excretion.
