EFFECTIVENESS OF A SOMATOSTATIN ANALOG IN LOWERING LUTEINIZING-HORMONE AND INSULIN-STIMULATED SECRETION IN HYPERINSULINEMIC WOMEN WITH POLYCYSTIC OVARY DISEASE

Objective: To analyze the action of a long-acting somatostatin analogue on circulating insulin levels and on pituitary sensitivity to GnRH in women affected by polycystic ovary disease (PCOD). Design: Controlled clinical study. Setting: Normal human volunteers in the Department of Obstetrics and Gynecology, Universita' Cattolica del Sacro Cuore. Patients: Twenty euglycemic women affected by PCOD, aged 19 to 30 years, were studied in their early follicular phase. Interventions: A long-acting somatostatin analogue (octreotide) was administered SC for 6 weeks; an oral glucose tolerance test (OGTT), a GnRH test, and plasma hormone determinations were performed at baseline and repeated after 6 weeks of treatment. A glucose load also was performed after 1 week of treatment. Main Outcome Measures: Insulin and glucose serum concentrations were measured in all samples under the oral glucose stimulus, LH and FSH were measured under GnRH test. Plasma levels of PRL, sex hormone-binding globulin, androstenedione (A), T, 17 beta-hydroxyprogesterone, DHEAS, and cortisol were measured. Steroids also were assayed after the octreotide administration. Results: Based on the insulin response to OGTT, subjects were classified as hyperinsulinemic (n = 12) and normoinsulinemic (n = 8). Octreotide administration did not affect the glycemic levels in both groups. Octreotide significantly reduced insulin and LH exaggerated response to GnRH stimulus, as well as the A and T circulating levels, only in the hyperinsulinemic group. Conclusions: A functional linkage exists between exaggerated insulin and LH-stimulated secretion in a group of polycystic ovary patients. Octreotide may be useful in normalizing these alterations and in reducing ovarian androgen secretion of hyperinsulinemic subjects.