Efficacy of octreotide-LAR in dieting women with abdominal obesity and polycystic ovary syndrome

被引:47
作者
Gambineri, A
Patton, L
De Iasio, R
Cantelli, B
Cognini, GE
Filicori, M
Barreca, A
Kandarakis, ED
Pagotto, U
Pasquali, R
机构
[1] St Orsola Marcello Malpighi Hosp, Ctr Appl Biomed Res, I-40138 Bologna, Italy
[2] Univ Bologna, Ctr Reprod Endocrinol, I-40138 Bologna, Italy
[3] Univ Genoa, Dept Endocrinol & Metab Sci, I-16132 Genoa, Italy
[4] Univ Genoa, Ctr Excellence Biomed Res, I-16132 Genoa, Italy
[5] Univ Athens, Sch Med, Laiko Gen Hosp, Dept Internal Med 1,Endocrine Sect, Athens 17562, Greece
关键词
D O I
10.1210/jc.2004-2490
中图分类号
R5 [内科学];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
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.
引用
收藏
页码:3854 / 3862
页数:9
相关论文
共 40 条
[1]
[Anonymous], 1997, WHONUTNCD981
[2]
BAECKE JAH, 1982, AM J CLIN NUTR, V36, P939
[3]
Ghrelin secretion in humans is sexually dimorphic, suppressed by somatostatin, and not affected by the ambient growth hormone levels [J].
Barkan, AL ;
Dimaraki, EV ;
Jessup, SK ;
Symons, KV ;
Ermolenko, M ;
Jaffe, CA .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2003, 88 (05) :2180-2184
[4]
Dose-dependent effect of octreotide on insulin secretion after OGTT in obesity [J].
Bertoli, A ;
Magnaterra, R ;
Borboni, P ;
Marini, MA ;
Barini, A ;
Fusco, A ;
Bollea, MR .
HORMONE RESEARCH, 1998, 49 (01) :17-21
[5]
HYPOTHALAMIC POLYPEPTIDE THAT INHIBITS SECRETION OF IMMUNOREACTIVE PITUITARY GROWTH-HORMONE [J].
BRAZEAU, P ;
VALE, W ;
BURGUS, R ;
LING, N ;
BUTCHER, M ;
RIVIER, J ;
GUILLEMIN, R .
SCIENCE, 1973, 179 (4068) :77-79
[6]
INHIBITION BY SOMATOSTATIN OF LH-RH-INDUCED LH-RELEASE IN NORMAL MENSTRUATING WOMEN [J].
CHIODERA, P ;
VOLPI, R ;
DAMATO, L ;
FATONE, M ;
CIGARINI, C ;
FAVA, A ;
CAIAZZA, A ;
ROSSI, G ;
COIRO, V .
GYNECOLOGIC AND OBSTETRIC INVESTIGATION, 1986, 22 (01) :17-21
[7]
Endocrine and metabolic effects of ostreotide, a somatostatin analogue, in lean PCOS patients with either hyperinsulinaemia or lean normoinsulinaemia [J].
Ciotta, L ;
De Leo, V ;
Galvani, F ;
La Marca, A ;
Cianci, A .
HUMAN REPRODUCTION, 1999, 14 (12) :2951-2958
[8]
Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS) [J].
Fauser, BCJM ;
Chang, J ;
Azziz, R ;
Legro, R ;
Dewailly, D ;
Franks, S ;
Tarlatzis, BC ;
Fauser, B ;
Balen, A ;
Bouchard, P ;
Dahlgren, E ;
Devoto, L ;
Diamanti, E ;
Dunaif, A ;
Filicori, M ;
Homburg, R ;
Ibanez, L ;
Laven, J ;
Magoffin, D ;
Nestler, J ;
Norman, RJ ;
Pasquali, R ;
Pugeat, M ;
Strauss, J ;
Tan, S ;
Taylor, A ;
Wild, R ;
Wild, S ;
Ehrmann, D ;
Lobo, R .
HUMAN REPRODUCTION, 2004, 19 (01) :41-47
[9]
CLINICAL ASSESSMENT OF BODY HAIR GROWTH IN WOMEN [J].
FERRIMAN, D ;
GALLWEY, JD .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1961, 21 (11) :1440-+
[10]
Assessment and management of anovulatory infertility in polycystic ovary syndrome [J].
Franks, S .
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA, 2003, 32 (03) :639-+