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Oral contraceptive plus antiandrogen therapy and cardiometabolic risk in polycystic ovary syndrome
Author(s) -
Harmanci Ayla,
Cinar Nese,
Bayraktar Miyase,
Yildiz Bulent Okan
Publication year - 2013
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.1365-2265.2012.04466.x
Subject(s) - medicine , endocrinology , polycystic ovary , antiandrogen , hyperandrogenism , body mass index , hirsutism , spironolactone , homocysteine , insulin , androgen , insulin resistance , hormone , aldosterone
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 (hs CRP ), 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 μg) plus spironolactone (100 mg/day) for 6 months. Healthy controls were evaluated at baseline only. Results hs CRP , homocysteine, lipids, insulin and glucose levels were similar between patient and control groups at baseline. EE ‐ DRSP plus spironolactone increased hs CRP 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 μ m , P < 0·05, respectively). BMI , waist‐to‐hip ratio, LDL , HDL cholesterol and triglycerides, and glucose tolerance did not change. Modified F erriman– G allwey 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 hs CRP and homocysteine levels.