Treatment with flutamide improves hyperinsulinemia in women with idiopathic hirsutism

被引:40
作者
Paoletti, AM
Cagnacci, AE
Orrù, M
Ajossa, S
Guerriero, S
Melis, GB
机构
[1] Univ Cagliari, Ist Ginecol Ostetr & Fisiopatol Riprod Umana, I-09124 Cagliari, Italy
[2] Univ Modena, Ist Ginecol & Ostetr, I-41100 Modena, Italy
关键词
hyperinsulinemia; androgens; flutamide; PCOS; idiopathic hirsutism;
D O I
10.1016/S0015-0282(99)00275-7
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To investigate insulin metabolism and its modifications induced by the administration of flutamide, a specific antiandrogen compound, in women with idiopathic hirsutism (IH) and in nonobese women with polycystic ovary syndrome (PCOS). Design: Prospective, randomized trial. Setting: Endocrinological Centre of the Department of Obsterics and Gynecology, University of Caligari, Caligari, Italy. Patient(s): Thirty-two women with normal body mass index participated in the study: 11 with clinical and hormonal features of PCOS and 21 age- and weight-matched normally cycling women with IH (n = 11) and without IH (n = 10, controls). Intervention(s): Each subject with PCOS or IH was assigned randomly to receive either flutamide tablets (250 mg twice a day) or placebo for greater than or equal to 5 months. Twelve subjects (6 with PCOS, 6 with IH) received flutamide and 10 (5 with PCOS, 5 with IH) received placebo. All subjects ingested 75 g of glucose and then underwent an oral glucose tolerance test (OGTT), 3-7 days after spontaneous or medroxyprogesterone acetate (5 mg daily for 5 days)-induced menses. Tn women with PCOS or IH, the OGTT was treated at the fourth month of treatment. Main Outcome Measure(s): Easting and OGTT-stimulated levels of glucose, insulin, and C peptide. Result(s): Both fasting and OGTT; stimulated levels of insulin and C peptide were significantly higher in women with PCOS and in those with IH than in controls. Placebo did not modify parameters of glucose metabolism. Flutamide was capable of significantly blunting fasting and OGTT-stimulated secretion of insulin only in women with III. Conclusion(s): Hyperinsulinemia exists in women with TH as well as in nonobese women with PCOS. Treatment with flutamide can completely reverse hyperinsulinemia only in women with IH, which suggests that the efficacy of the drug is dependent on peripheral androgen hyperactivity. (Fertil Steril(R) 1999;72: 448-53. (C) 1999 by American Society for Reproductive Medicine.)
引用
收藏
页码:448 / 453
页数:6
相关论文
共 25 条
[11]  
FRUZZETTI F, 1993, FERTIL STERIL, V60, P806
[12]  
GEFFNER ME, 1986, FERTIL STERIL, V45, P327
[13]  
HENNES MMI, 1990, INT J OBESITY, V14, P831
[14]   EFFECTS OF SHORT-TERM TESTOSTERONE EXPOSURE ON INSULIN SENSITIVITY OF MUSCLES IN FEMALE RATS [J].
HOLMANG, A ;
LARSSON, BM ;
BRZEZINSKA, Z ;
BJORNTORP, P .
AMERICAN JOURNAL OF PHYSIOLOGY, 1992, 262 (06) :E851-E855
[15]  
LOBO RA, 1991, INFERTILITY CONTRACE, P422
[16]   The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: Evidence that androgens impair insulin action in women [J].
Moghetti, P ;
Tosi, F ;
Castello, R ;
Magnani, CM ;
Negri, C ;
Brun, E ;
Furlani, L ;
Caputo, M ;
Muggeo, M .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1996, 81 (03) :952-960
[17]   The chronic administration of cabergoline normalizes androgen secretion and improves menstrual cyclicity in women with polycystic ovary syndrome [J].
Paoletti, AM ;
Cagnacci, A ;
Depau, GF ;
Orru, M ;
Ajossa, S ;
Melis, GB .
FERTILITY AND STERILITY, 1996, 66 (04) :527-532
[18]   INHIBITION OF SEX HORMONE-BINDING GLOBULIN PRODUCTION IN THE HUMAN HEPATOMA (HEP-G2) CELL-LINE BY INSULIN AND PROLACTIN [J].
PLYMATE, SR ;
MATEJ, LA ;
JONES, RE ;
FRIEDL, KE .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1988, 67 (03) :460-464
[19]   C-PEPTIDE AS A MEASURE OF THE SECRETION AND HEPATIC EXTRACTION OF INSULIN - PITFALLS AND LIMITATIONS [J].
POLONSKY, KS ;
RUBENSTEIN, AH .
DIABETES, 1984, 33 (05) :486-494
[20]   SPECIFIC INSULIN BINDING-SITES IN HUMAN-OVARY [J].
PORETSKY, L ;
SMITH, D ;
SEIBEL, M ;
PAZIANOS, A ;
MOSES, AC ;
FLIER, JS .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1984, 59 (04) :809-811