Effect of pioglitazone on glucose metabolism and luteinizing hormone secretion in women with polycystic ovary syndrome

Dorte Glintborg, Anne Pernille Hermann, Marianne Andersen, Claus Hagen, Henning Beck-Nielsen, Johannes D. Veldhuis, Jan Erik Henriksen

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Objective: To thoroughly examine the mechanisms for insulin resistance in polycystic ovary syndrome (PCOS) and to evaluate the effects of pioglitazone treatment on insulin resistance, β-cell function, LH secretion, and glucose metabolism. Design: Randomized, blinded, placebo-controlled study. Setting: Outpatient clinic, at a university hospital in Denmark. Patient(s): Thirty obese women with PCOS and 14 weight-matched healthy females. Intervention(s): Sixteen weeks of blinded treatment with pioglitazone (30 mg/d) or placebo. Main Outcome Measure(s): Fasting blood samples, 24-hour 20-minute integrated blood sampling (LH, insulin, and C-peptide), euglycemic hyperinsulinemic clamps including 3-3H glucose, and indirect calorimetry were performed before and after the intervention period. Result(s): Patients with PCOS had significantly lower insulin sensitivity compared with controls, including significantly decreased insulin-stimulated oxidative and nonoxidative glucose metabolism. Pioglitazone treatment resulted in significantly lower levels of fasting insulin and significantly higher insulin sensitivity, increased insulin-stimulated glucose oxidation, and increased insulin-stimulated inhibition of lipid oxidation. During 24-hour blood sampling, significantly lower area under-the-curve insulin and lower median insulin levels were observed. Secretion profiles of LH and E2 and T levels did not change significantly. Conclusion(s): Insulin resistance in PCOS was characterized by hyperinsulinemia, impaired insulin-stimulated oxidative and nonoxidative glucose metabolism, which was partly reversed by pioglitazone treatment.

Original languageEnglish (US)
Pages (from-to)385-397
Number of pages13
JournalFertility and sterility
Volume86
Issue number2
DOIs
StatePublished - Aug 2006

Keywords

  • LH secretion
  • PCOS
  • PPAR-γ agonist
  • glucose metabolism
  • hyperinsulinemic clamp
  • indirect calorimetry
  • insulin resistance
  • lipid metabolism
  • pioglitazone
  • β-cell function

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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