Rosiglitazone treatment increases plasma levels of adiponectin and decreases levels of resistin in overweight women with PCOS: a randomized placebo-controlled study

Abstract

Objective: Abdominal obesity, insulin resistance and compensatory hyperinsulinaemia play a central role in the pathogenesis of the polycystic ovary syndrome (PCOS). Abdominal adipose tissue is a source of adipokines, such as adiponectin and resistin, both of which may be involved in the development of insulin resistance and chronic inflammation in PCOS. Ghrelin, an important regulatory peptide of food intake, may also play a role in metabolic disturbances related to PCOS.The aim of this study was to examine the effects of 4 months of treatment with the insulin sensitizer rosiglitazone on plasma adiponectin, resistin and ghrelin levels in overweight women with PCOS. Design: A randomised placebo-controlled study. Methods: Thirty overweight/obese women with PCOS (body mass indexO25 kg/m 2 , mean age 29.1G 1.2 (S.E.M.) years) were randomly allocated to either rosiglitazone (Avandia, 4 mg twice a day) or placebo treatment. Plasma levels of adiponectin, resistin and ghrelin and their correlation to serum levels of insulin, C-peptide and steroid hormones, and insulin sensitivity (euglycaemic hyperinsulinaemic clamp) were assessed. Results: Adiponectin and ghrelin levels correlated significantly with most metabolic markers of insulin resistance and with serum levels of DHEA and 17-hydroxyprogesterone. Plasma levels of adiponectin increased from 9.26G0.90 (S.E.M.) to 22.22G3.66 mg/ml (P!0.001) and those of resistin decreased from 12.57G1.63 to 9.21G0.53 ng/ml (PZ0.009) at 4 months of treatment, but plasma ghrelin levels did not change. Conclusions: Rosiglitazone had beneficial effects on serum levels of adiponectin and resistin, suggesting that these adipocytokines may contribute to the improvement in insulin sensitivity observed during the treatment.

Thiazolidinediones as anti‐inflammatory and anti‐atherogenic agents

“…Similarly, a trial involving 70 patients without diabetes but with the metabolic syndrome found that adiponectin levels were significantly increased by 164% (p < 0.001) after 8 weeks of treatment with rosiglitazone, compared with placebo [68]. Four months of treatment with rosiglitazone also significantly increased plasma levels of adiponectin when compared with placebo (p < 0.001) in a study of 30 overweight/obese women with polycystic ovary syndrome [59].…”

Weight gain by hyperalimentation elevates C-reactive protein levels but does not affect circulating levels of adiponectin or resistin in healthy subjects

“…The clinical correlates of levels of adipokines are corroborated by the finding that the circulating levels of resistin in humans are lowered by treatment with the anti-diabetic insulin-sensitizing PPARG agonist drugs rosiglitazone and pioglitazone, while such treatment concomitantly increases the levels of adiponectin (15)(16)(17).…”

Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome

“…Instead, the resistin gene polymorphism is associated with BMI in women with PCOS, suggesting that resistin might be related to adiposity in PCOS (Xita et al 2004). In addition, in a randomized placebo-controlled study, treatment with the insulin sensitizer rosiglitazone significantly reduced serum resistin levels in overweight women with PCOS, implying the contribution of resistin to insulin sensitivity improvement during treatment (Majuri et al 2007). In summary, resistin seems to be an important adipokine that is involved in obesity, IR, and PCOS.…”