Comparison of effects of 3 mg drospirenone plus 20 µg ethinyl estradiol alone or combined with metformin or cyproterone acetate on classic metabolic cardiovascular risk factors in nonobese women with polycystic ovary syndrome
| Autor: | Daria Perini, Donatella Parrini, Veronica Lazzarini, Andrea R. Genazzani, Franca Fruzzetti, Marco Gambacciani |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Administration Oral Blood Pressure Ethinyl Estradiol chemistry.chemical_compound Young Adult Insulin resistance Risk Factors Internal medicine medicine Humans Hypoglycemic Agents Insulin Cyproterone Mineralocorticoid Receptor Antagonists medicine.diagnostic_test Dose-Response Relationship Drug business.industry Obstetrics and Gynecology Cyproterone acetate Drospirenone Estrogens medicine.disease Polycystic ovary Lipids Metformin Endocrinology Glucose Reproductive Medicine chemistry Cardiovascular Diseases Androgens Androstenes Drug Therapy Combination Female business Lipid profile medicine.drug Polycystic Ovary Syndrome |
| Popis: | Objective To evaluate the effects of a pill with drospirenone (3 mg) plus ethinyl E 2 (20 μg) (DRP/20EE) alone or associated with metformin or cyproterone acetate (CPA) on some metabolic cardiovascular risk factors in women with polycystic ovary syndrome (PCOS). Design Randomized, open-label clinical trial. Setting Academic medical clinic. Patient(s) Forty-eight hirsute women with PCOS. Intervention(s) Patients were randomized to treatment with DRP/20EE or with DRP/20EE plus metformin (1,500 mg/d) or with DRP/20EE plus CPA (12.5 mg/d, 10 days per cycle) for 6 months. Main Outcome Measure(s) Blood pressure, lipid profile, and indexes of glucose tolerance and insulin sensitivity were assessed before and after 6 months of treatment. Result(s) Body mass index and blood pressure were not modified by any treatment. Treatment with DRP/EE20 did not change the lipid profile; DRP/EE20 plus metformin significantly increased high-density lipoprotein cholesterol concentrations; DRP/EE20 plus CPA significantly increased triglycerides and total cholesterol. The area under the curve for insulin was significantly decreased by DRP/EE20 and DRP/EE20 plus metformin, but it was significantly increased by DRP/EE20 plus CPA. Treatment with DRP/EE20 plus CPA significantly increased the homeostasis model assessment of insulin resistance index and significantly reduced the glucose to insulin ratio index. Treatment with DRP/EE20 significantly increased the glucose to insulin ratio index. Conclusion(s) Treatment with DRP/EE20 improved insulin sensitivity in hirsute women with PCOS, with no deterioration of lipid profile. This effect was not ameliorated by the addition of metformin. The positive metabolic effects of DRP are abolished by the concomitant use of CPA. |
| Databáze: | OpenAIRE |
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