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Pioglitazone (7·5 mg/day) added to flutamide–metformin in women with androgen excess: additional increments of visfatin and high molecular weight adiponectin
Author(s) -
Ibáñez Lourdes,
LópezBermejo Abel,
Díaz Marta,
Enríquez Goya,
Valls Carme,
De Zegher Francis
Publication year - 2008
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2007.03137.x
Subject(s) - medicine , endocrinology , adiponectin , flutamide , metformin , androgen excess , pioglitazone , androgen , polycystic ovary , insulin resistance , obesity , insulin , type 2 diabetes , androgen receptor , prostate cancer , diabetes mellitus , hormone , cancer
Summary Background and aim Low‐dose pioglitazone (Pio), flutamide (Flu), metformin (Met) plus an oestro‐progestagen is a novel polytherapy lowering total and visceral adiposity, and reducing carotid intima media thickness (IMT) in hyperinsulinaemic women with androgen excess, without changing their body mass index (BMI). In a search for mediators of PioFluMet's actions, we measured serum levels of visfatin and high molecular weight (HMW) adiponectin. Design and patients In a double‐blind study, we enrolled 38 young women with hyperinsulinaemic androgen excess [mean BMI: 23·7 kg/m 2 ], all of whom started on Flu (62·5 mg/day), Met (850 mg/day) and a transdermal oestro‐progestagen, each for 21/28 days over 1 year. Patients were randomly assigned to receive, in addition, placebo ( n = 19) or Pio (7·5 mg/day; n = 19) on the same 21/28 days. Measurements Serum concentrations of visfatin and HMW adiponectin, visceral fat by magnetic resonance imaging, carotid IMT by ultrasound, all carried out during study start and after 1 year. Results PioFluMet raised visfatin by a mean 84% and HMW adiponectin by 157% ( P < 0·001), and reduced visceral fat and IMT by a mean 22% and 31% (both P < 0·001). Low‐dose Pio accounted for about half of the PioFluMet effects on IMT, visfatin and HMW adiponectin. Conclusion In hyperinsulinaemic women with androgen excess, low‐dose polytherapy with PioFluMet evoked striking rises in both circulating visfatin and HMW adiponectin, while lowering IMT and reducing visceral adiposity within 1 year.