Effect of Two Modes of Antiandrogen Treatment on Insulin Sensitivity and Serum Leptin in Women with PCOS

Krotkiewski, M; Landin, Kerstin; Dahlgren, Eva; Janson, Per Olof; Holm, Göran

doi:10.1159/000070180

Cited by 15 publications

(11 citation statements)

References 35 publications

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“…Our findings of insignificant associations between leptin and androgen levels are in agreement with previous studies (42,(44)(45)(46). Further supporting a minor relation between testosterone and leptin, Krotkiewski et al (48) found no significant changes of leptin levels during anti-androgen treatment in PCOS.…”

Section: Whr Adjustedsupporting

confidence: 93%

Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

et al. 2006

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Objective: Polycystic ovary syndrome (PCOS) patients are abdominally obese and are at increased risk of developing the metabolic syndrome. Low adiponectin and ghrelin levels in PCOS patients could be caused by insulin resistance as well as high testosterone levels. Design: Adiponectin and ghrelin levels were evaluated in 51 hirsute PCOS patients referred to the outpatient clinic of an academic, tertiary care medical centre and in 63 weight-matched female controls. Relationships between adiponectin, ghrelin, leptin, body composition, testosterone and insulin were examined. Methods: Measurements of body composition including waist-hip-ratio (WHR), body mass index (BMI) and whole body dual-energy X-ray absorptiometry scan measures of body fat mass. Measurements of fasting levels of adiponectin, ghrelin, leptin, androgen status, oestradiol, lipid variables and insulin during follicular phase. Results: Adiponectin levels were significantly decreased in obese PCOS patients compared with weightmatched controls (geometric mean (K2 to 2 S.D.) 5.3 (2.5-11.1) vs 7.3 (3.0-17.4) mg/l, P!0.05). Mean ghrelin was significantly lower in hirsute PCOS patients than in controls (0.6 (0.3 to 1.4) vs 0.8 (0.4 to 1.7) mg/l, P!0.001) and this remained significant after subdividing subjects according to waist circumference and BMI. During multiple regression analysis, testosterone correlated positively with adiponectin and negatively with ghrelin independent of BMI, WHR and total fat mass. Conclusion: Obese hirsute PCOS patients demonstrated significantly lower adiponectin levels than weight-matched controls suggesting a very high risk for the metabolic syndrome. Furthermore, ghrelin levels were decreased in hirsute PCOS patients and showed a significant, negative correlation with testosterone independent of body composition.European Journal of Endocrinology 155 337-345

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Section: Whr Adjustedsupporting

confidence: 93%

Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

et al. 2006

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“…However, there were a few studies with other antiandrogenic therapies. Krotkiewski et al found no significant changes in leptin levels during antiandrogen treatment (EE and cyproteroneacetate) in PCOS (45). Nevertheless, in the studies with oral contraceptives including desogestrel (a third-generation oral contraceptive), no change of the leptin levels was observed in normal menstruating women at 3 and/or 6 months of treatment (46,47).…”

Section: Figurementioning

confidence: 98%

The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin and ghrelin in polycystic ovary syndrome

Sağsöz

Orbak

Noyan

et al. 2009

Fertility and Sterility

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“…In a study of 43 hyperandrogenic women (hirsutism alone or PCOS), treated with either GnRH analogues or the androgen receptor antagonists spironolactone or flutamide, the impairment in insulin-stimulated glucose uptake at baseline was partially reversed at 3-4 months post-therapy [77]. Similarly, in two studies each of eight women with PCOS, treatment with GnRH analogues for 6 months resulted in improved insulin sensitivity [79,80]. In contrast, in two studies of 18 women and 17 women with PCOS treated with flutamide for 3 months, insulin-stimulated glucose disposal was unchanged [75,78].…”

Section: Intervention Studies In Women With Hyperandrogenismmentioning

confidence: 99%

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

Corbould

2008

Diabetes Metabolism Res

122

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Hyperinsulinemia as a consequence of insulin resistance causes hyperandrogenemia in women. The objective was to review evidence for the converse situation, i.e. whether androgens adversely influence insulin action. Androgen excess could potentially contribute to the pathogenesis of insulin resistance in women with polycystic ovary syndrome (PCOS), metabolic syndrome/type 2 diabetes, and in obese peripubertal girls. An Entrez-PubMed search was conducted to identify studies addressing the relationship of androgens with metabolic syndrome/type 2 diabetes in women. Studies reporting outcomes of androgen administration, interventions to reduce androgen effects in hyperandrogenemic women, and basic studies investigating androgen effects on insulin target tissues were reviewed. Multiple studies showed associations between serum testosterone and insulin resistance or metabolic syndrome/type 2 diabetes risk in women, but their cross-sectional nature did not allow conclusions about causality. Androgen administration to healthy women was associated with development of insulin resistance. Intervention studies in women with hyperandrogenism were limited by small subject numbers and use of indirect methods for assessing insulin sensitivity. However, in three of the seven studies using euglycemic hyperinsulinemic clamps, reduction of androgen levels or blockade of androgen action improved insulin sensitivity. Testosterone administration to female rats caused skeletal muscle insulin resistance. Testosterone induced insulin resistance in adipocytes of women in vitro. In conclusion, the metabolic consequences of androgen excess in women have been under-researched. Studies of long-term interventions that lower androgen levels or block androgen effects in young women with hyperandrogenism are needed to determine whether these might protect against metabolic syndrome/type 2 diabetes in later life.

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Effect of Two Modes of Antiandrogen Treatment on Insulin Sensitivity and Serum Leptin in Women with PCOS

Cited by 15 publications

References 35 publications

Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls

The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin and ghrelin in polycystic ovary syndrome

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

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