Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P231

ECE2007 Poster Presentations (1) (659 abstracts)

Pioglitazone treatment significantly decreases 5-alpha reductase activity and improves metabolic risk factors in PCOS

Dorte Glintborg 1 , Anne Pernille Hermann 1 , Claus Hagen 1 , Johannes Veldhuis 2 , Anne Schmedes 3 , Jan Frystyk 4 , Allan Flyvbjerg 4 & Marianne Andersen 1

1Department of Endocrinology and Metabolism, Odense University Hospital, DK-5000 Odense C, Denmark; 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinical Research Center, Rochester, United States; 3Department of Clinical Chemistry, Vejle Hospital, DK-7100 Vejle, Denmark; 4Medical Research Laboratories, Clinical Institute and Medical Department M (Diabetes and Endocrinology), Aarhus University Hospita, DK-8000 Aarhus, Denmark.

Objective: To investigate the effect of pioglitazone on cortisol metabolism in PCOS.

Design: Thirty insulin resistant PCOS patients were randomized to either 16 weeks of pioglitazone (30 mg/day) or placebo treatment. Before and after intervention, patients underwent 24 h 20 min.-integrated blood sampling for measurement of cortisol and 24 h excretion of cortisol, cortisone and steroid metabolites (cortisol, corticosteron, androgen, and 17-hydroxyprogesteron) were measured in urine. Fasting insulin, adiponectin, testosterone, dihydrotestosterone (DHT), and dehydroepiandrosteronsulfate (DHAS) was measured. 5-alfa reductase activity was evaluated by alloTHF/THF and androsteron/ethiocholanolon ratios. Delta values (Δ) denoted changes during the treatment period.

Results: Pioglitazone treatment was followed by significantly decreased 5-alfa reductase activity as evaluated by alloTHF/THF levels. Δ-androsteron/ethiocholanolon showed a significant negative correlation with Δ-IGF-I and Δ-peak GH level during PD-GHRH test. Furthermore, a significant negative correlation was found between Δ- alloTHF/THF and Δ- adiponectin levels.

No significant changes were measured in 24 h mean cortisol levels or urine excretion of cortisol, cortisone or steroid metabolites.

Insulin sensitivity, GH, adiponectin, and IGF-I was significantly increased during pioglitazone treatment.

Conclusion: Pioglitazone treatment was followed by significantly decreased 5-alfa reductase activity which was inversely correlated with IGF-I, GH, and adiponectin levels. These results suggest important relations between 5-alfa reductase activity and the GH/IGF-I system as well as metabolic risk factors.

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