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Pioglitazone for treating polycystic ovary syndrome in non-obese women of reproductive age with different clinical presentations.
Gynecol Endocrinol 2007; 23(8):461-7GE

Abstract

AIMS

To evaluate the effects of pioglitazone on menstruation and the metabolic parameters of non-obese women of reproductive age with polycystic ovary syndrome (PCOS) and compare the effects among different subgroups of PCOS patients with different clinical presentations.

METHODS

Twenty-eight women of reproductive age with PCOS were recruited; 20 women finished the study. The women were divided into three groups according to clinical presentations: group A (n = 4) had chronic oligo- or anovulation with polycystic ovaries; group B (n = 5) had chronic oligo- or anovulation with hyperandrogenism; and group C (n = 11) had chronic oligo- or anovulation, hyperandrogenism and polycystic ovaries. Pioglitazone (15 mg/day) was given for 6 months and the therapeutic effects were evaluated. Menstrual cycle regularity and hormone levels (plasma luteinizing hormone (LH), follicle-stimulating hormone, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, insulin, C-peptide, free testosterone, homeostatic model assessment (HOMA)) were evaluated during and after pioglitazone treatment.

RESULTS

Thirty percent and 45.5% of the patients showed improvement of menstrual cycle regularity immediately after completion of treatment and at 6 months after completion of pioglitazone treatment, respectively, although there were no statistical differences among the subgroups. There was a significant difference in the change of body mass index (BMI) throughout the study period among the subgroups (p = 0.008). The decrease in BMI was significantly higher in group B than in groups A and C at 3 months (p = 0.0381) and 6 months of treatment (p = 0.0054), as well as at 6 months after completion of treatment (p = 0.003). HDL-C concentrations increased throughout the period (p = 0.001) without a difference among the subgroups. LH levels decreased at 6 months of treatment and throughout the follow-up period (p = 0.0045), but this did not differ among subgroups. The free testosterone level decreased, but without significance. There was no statistical improvement in any of the parameters of insulin resistance, but baseline free testosterone levels were related to the improvement of the HOMA insulin sensitivity score (p = 0.0009). Patients with more than a 50% decrease of their HOMA insulin resistance (HOMA-IR) score showed higher baseline free testosterone levels (hyperandrogenic groups B and C) than did the patients with less than 50% HOMA-IR score improvement or those patients with an increased HOMA-IR score.

CONCLUSIONS

These preliminary results suggest that pioglitazone treatment for non-obese PCOS women of reproductive age may be effective to help the resumption of the menstrual cycle, and the patients showed a different response pattern according to their baseline free testosterone levels.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17852414

Citation

Koo, Young-Ah, et al. "Pioglitazone for Treating Polycystic Ovary Syndrome in Non-obese Women of Reproductive Age With Different Clinical Presentations." Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, vol. 23, no. 8, 2007, pp. 461-7.
Koo YA, Shin SY, Yoon BK, et al. Pioglitazone for treating polycystic ovary syndrome in non-obese women of reproductive age with different clinical presentations. Gynecol Endocrinol. 2007;23(8):461-7.
Koo, Y. A., Shin, S. Y., Yoon, B. K., & Choi, D. (2007). Pioglitazone for treating polycystic ovary syndrome in non-obese women of reproductive age with different clinical presentations. Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, 23(8), pp. 461-7.
Koo YA, et al. Pioglitazone for Treating Polycystic Ovary Syndrome in Non-obese Women of Reproductive Age With Different Clinical Presentations. Gynecol Endocrinol. 2007;23(8):461-7. PubMed PMID: 17852414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pioglitazone for treating polycystic ovary syndrome in non-obese women of reproductive age with different clinical presentations. AU - Koo,Young-Ah, AU - Shin,So-Young, AU - Yoon,Byung-Koo, AU - Choi,Dooseok, PY - 2007/9/14/pubmed PY - 2010/1/27/medline PY - 2007/9/14/entrez SP - 461 EP - 7 JF - Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology JO - Gynecol. Endocrinol. VL - 23 IS - 8 N2 - AIMS: To evaluate the effects of pioglitazone on menstruation and the metabolic parameters of non-obese women of reproductive age with polycystic ovary syndrome (PCOS) and compare the effects among different subgroups of PCOS patients with different clinical presentations. METHODS: Twenty-eight women of reproductive age with PCOS were recruited; 20 women finished the study. The women were divided into three groups according to clinical presentations: group A (n = 4) had chronic oligo- or anovulation with polycystic ovaries; group B (n = 5) had chronic oligo- or anovulation with hyperandrogenism; and group C (n = 11) had chronic oligo- or anovulation, hyperandrogenism and polycystic ovaries. Pioglitazone (15 mg/day) was given for 6 months and the therapeutic effects were evaluated. Menstrual cycle regularity and hormone levels (plasma luteinizing hormone (LH), follicle-stimulating hormone, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, insulin, C-peptide, free testosterone, homeostatic model assessment (HOMA)) were evaluated during and after pioglitazone treatment. RESULTS: Thirty percent and 45.5% of the patients showed improvement of menstrual cycle regularity immediately after completion of treatment and at 6 months after completion of pioglitazone treatment, respectively, although there were no statistical differences among the subgroups. There was a significant difference in the change of body mass index (BMI) throughout the study period among the subgroups (p = 0.008). The decrease in BMI was significantly higher in group B than in groups A and C at 3 months (p = 0.0381) and 6 months of treatment (p = 0.0054), as well as at 6 months after completion of treatment (p = 0.003). HDL-C concentrations increased throughout the period (p = 0.001) without a difference among the subgroups. LH levels decreased at 6 months of treatment and throughout the follow-up period (p = 0.0045), but this did not differ among subgroups. The free testosterone level decreased, but without significance. There was no statistical improvement in any of the parameters of insulin resistance, but baseline free testosterone levels were related to the improvement of the HOMA insulin sensitivity score (p = 0.0009). Patients with more than a 50% decrease of their HOMA insulin resistance (HOMA-IR) score showed higher baseline free testosterone levels (hyperandrogenic groups B and C) than did the patients with less than 50% HOMA-IR score improvement or those patients with an increased HOMA-IR score. CONCLUSIONS: These preliminary results suggest that pioglitazone treatment for non-obese PCOS women of reproductive age may be effective to help the resumption of the menstrual cycle, and the patients showed a different response pattern according to their baseline free testosterone levels. SN - 1473-0766 UR - https://www.unboundmedicine.com/medline/citation/17852414/Pioglitazone_for_treating_polycystic_ovary_syndrome_in_non_obese_women_of_reproductive_age_with_different_clinical_presentations_ L2 - http://www.tandfonline.com/doi/full/10.1080/09513590701492689 DB - PRIME DP - Unbound Medicine ER -