Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Effects of Pioglitazone on Insulin Sensitivity, Ovarian Function and Intraovarian Stromal Blood Flow in Women with Polycystic Ovary Syndrome

다낭성난소증후군 환자에서 Pioglitazone이 인슐린 민감도, 난소 기능, 난소 기질 내 혈류에 미치는 영향

  • Lee, Hyang-Ah (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Kim, Chung-Hoon (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Choi, Jeong-Won (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Park, Sun-Jung (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Lee, Soo-Jeong (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Choi, Eun-Sun (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Kim, Sung-Hoon (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Chae, Hee-Dong (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center) ;
  • Son, Young-Soo (Department of Obstetrics and Gynecology, College of Medicine, Cheju University) ;
  • Kang, Byung-Moon (Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center)
  • 이향아 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 김정훈 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 최정원 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 박선정 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 이수정 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 최은선 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 김성훈 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 채희동 (울산대학교 의과대학 서울아산병원 산부인과학교실) ;
  • 손영수 (제주대학교 의과대학 산부인과) ;
  • 강병문 (울산대학교 의과대학 서울아산병원 산부인과학교실)
  • Published : 2005.06.30
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Abstract

Objective: This study was performed to investigate the effects of pioglitazone, an insulin sensitizing agent, on insulin resistance, ovarian function and intraovarian stromal blood flow in patients with polycystic ovarian syndrome (PCOS). Material and Methods: Thirty patients with PCOS, aged 18~34 years, were recruited. Criteria for diagnosis of PCOS were as defined in 2003 Rotterdam consensus. They were treated for 6 months with pioglitazone at a dose of 30 mg/day orally. The hormonal blood profile, fasting serum glucose levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and an ovarian stromal artery (OSA) blood flow were assessed at baseline and after 6 months of treatment. Results: Eighteen (60.0%) of 30 patients treated with pioglitazone demonstrated a spontaneous ovulation After pioglitazone treatment, fasting insulin concentrations, serum glucose levels after 75 g OGTT significantly decreased (p=0.001, p=0.04, respectively), and fasting glucose to insulin (G/I) ratio significantly increased (p<0.001). The pioglitazone treatment induced a significant reduction in serum LH, testosterone (T) and free T levels (p<0.001, p=0.02, p=0.002, respectively). The resistance index (RI) values of OSA significantly increased after treatment (p<0.001). In analyzing pioglitazone-treated patients according to their body mass index (BMI), nonobese group as well as obese group showed a significant improvement in fasting G/I ratio (p<0.01). The pioglitazone treatment induced a significant reduction in serum LH and free T levels in nonobese group (p<0.001, p<0.05, respectively) as well as obese group (p=0.001, p<0.05, respectively). The RI values of OSA significantly increased in both nonobese and obese groups after pioglitazone treatment (p<0.001, p=0.003, respectively). Conclusions: Pioglitazone could ameliorate the glycoinsulinemic metabolism, and this beneficial effects of this drug could improve the endocrine-reproductive condition associated with the decrease of ovarian stromal artery blood flow, in both nonobese and obese patients with PCOS.

Keywords

References

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