Oral contraceptive plus antiandrogen therapy and cardiometabolic risk in polycystic ovary syndrome


HARMANCI A. , Cinar N., BAYRAKTAR M. , Yildiz B. O.

CLINICAL ENDOCRINOLOGY, cilt.78, sa.1, ss.120-125, 2013 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 78 Konu: 1
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1111/j.1365-2265.2012.04466.x
  • Dergi Adı: CLINICAL ENDOCRINOLOGY
  • Sayfa Sayıları: ss.120-125

Özet

Objective Oral contraceptives alone or in combination with antiandrogens are commonly used in the treatment for polycystic ovary syndrome (PCOS). We aimed to determine the effects of ethinyl estradiol/drospirenone (EE-DRSP) plus spironolactone therapy on inflammation and cardiometabolic risk in PCOS. Design Prospective cohort study. Patients Twenty-three lean, normal glucose-tolerant patients with PCOS and 23 age- and body mass index (BMI)-matched healthy control women. Measurements Androgens, high-sensitivity C-reactive protein (hsCRP), homocysteine, lipids, fasting insulin, and glucose levels during a standard 75-g, 2-h oral glucose tolerance test were measured. Patients with PCOS were evaluated before and after receiving EE-DRSP (3 mg/30 mu g) plus spironolactone (100 mg/day) for 6 months. Healthy controls were evaluated at baseline only. Results hsCRP, homocysteine, lipids, insulin and glucose levels were similar between patient and control groups at baseline. EE-DRSP plus spironolactone increased hsCRP and homocysteine levels in patients with PCOS (0.50 +/- 0.28 vs 1.5 +/- 1.3 mg/l, P < 0.05 and 13.1 +/- 5.2 vs 17.6 +/- 5.3 mu m, P < 0.05, respectively). BMI, waist-to-hip ratio, LDL, HDL cholesterol and triglycerides, and glucose tolerance did not change. Modified FerrimanGallwey hirsutism scores, testosterone levels and free androgen index improved (9.1 +/- 4.2 vs 6.2 +/- 3.4, P = 0.001; 80.6 +/- 31.1 47.8 +/- 20.3 ng/dl, P < 0.05; and 10.5 +/- 7.4 vs 1.1 +/- 0.8, P < 0.001, respectively). Conclusions EE-DRSP plus spironolactone therapy in 6 months improves androgen excess in lean PCOS women without any adverse effects on adiposity, glucose tolerance status or lipid profile. However, this combination increases hsCRP and homocysteine levels.