SOMATOSTATIN TREATMENT REDUCES THE EXAGGERATED RESPONSE OF ADRENOCORTICOTROPIN HORMONE AND CORTISOL TO CORTICOTROPIN-RELEASING HORMONE IN POLYCYSTIC-OVARY-SYNDROME

Objective: To evaluate the influence of somatostatin analogue (octreot ide) in the function of hypothalamic-pituitary-adrenal (HPA) axis in w omen with polycystic ovary syndrome (PCOS). Setting: Women referred to the Department of Obstetrics and Gynecology, Universita Cattolica del Sacro Cuore. Patient(s): Twelve PCOS women and 12 normo-ovulatory con trols. Intervention(s): In early follicular phase, I mu g/kg human cor ticotrophin-releasing hormone (CRH) was injected at 9:00 A.M. and bloo d samples were collected for 90 minutes after stimulus; ACTH and corti sol plasma levels were measured. The following day at 8:00 A.M., PCOS patients received an ACTH test (250 mu g IV) and samples were collecte d 60 minutes after injection. After 6 weeks of octreotide treatment (1 00 mg SC twice daily), PCOS patients repeated the same study. Main Out come Measure(s): Plasma cortisol and ACTH concentrations. Result(s): T he ACTH and cortisol baseline levels were similar in PCOS and control patients. The responses to human CRH of ACTH (incremental area = 437.8 6 +/- 188.7 versus 175.78 +/- 87.6 pmol/L; mean +/- SD) and cortisol ( incremental area = 17,293.6 +/- 4,320.3 versus 5,885 (912.1 nmol/L) we re significantly greater in PCOS with respect to control subjects. Aft er octreotide treatment, ACTH response significantly decreased and no difference was observed with respect to controls (incremental area = 1 76.94 +/- 91.4). Cortisol responses were decreased hy treatment. Howev er, they remained significantly higher than in controls. Treatment did not modify adrenal response to IV ACTH. Conclusion(s): Data suggest t hat, in the HPA axis, hyperfunction of PCOS somatostatin could be invo lved partially.