Περίληψη:
Context: Somatostatin reduces LH, GH, and insulin, and somatostatin
receptors are present at the ovarian level; somatostatin analogs are
thus potential candidates for treatment of the polycystic ovary syndrome
(PCOS).
Objective: The purpose of this study was to evaluate the effect of
octreotide-LAR, a long-acting somatostatin analog, in anovulatory
abdominal obese women with PCOS.
Design: A single-blind, placebo-controlled study was performed, lasting
for 7 months.
Setting: The patients were ambulatory throughout the study.
Patients: Twenty PCOS subjects were enrolled. Eighteen completed the
study.
Interventions: A low-calorie diet was given during the first month, a
low-calorie diet plus octreotide-LAR (10 mg; n = 10 subjects) or placebo
(n = 10 subjects) was then given, with one im injection every 28 d (for
6 months).
Main Outcome Measures: The main outcome measures were clinical features,
computerized tomography measurement of fat distribution, androgens, GH,
IGF-I, IGF-binding proteins (IGFBPs), fasting and glucose-stimulated
insulin, and ovulation.
Results: Octreotide had no additional effect in reducing body fat or
improving fat distribution than placebo. Conversely, octreotide produced
an additional decrease in fasting (P = 0.018) and glucose-stimulated (P
= 0.038) insulin levels, an increase in IGFBP-2 (P = 0.042) and IGFBP-3
(P = 0.047), and an improvement in hirsutism (P = 0.004). Moreover, a
trend toward greater reductions in testosterone (P = 0.061) and
androstenedione (P = 0.069) was observed in women treated with
octreotide-LAR compared with those given placebo. All women treated with
octreotide ovulated at the end of the study compared with only one of
those receiving placebo (P < 0.001).
Conclusions: Octreotide-LAR may be usefully applied to hypocalorically
dieting, abdominal obese PCOS women to improve hyperandrogenism and the
insulin-IGF-I system. Restoration of ovulatory menstrual cycles appears
to be another advantage of this treatment.
Συγγραφείς:
Gambineri, A
Patton, L
De Iasio, R
Cantelli, B
Cognini,
GE
Filicori, M
Barreca, A
Kandarakis, ED
Pagotto, U and
Pasquali, R
