EFFECTIVENESS OF A SOMATOSTATIN ANALOG IN LOWERING LUTEINIZING-HORMONE AND INSULIN-STIMULATED SECRETION IN HYPERINSULINEMIC WOMEN WITH POLYCYSTIC OVARY DISEASE
Am. Fulghesu et al., EFFECTIVENESS OF A SOMATOSTATIN ANALOG IN LOWERING LUTEINIZING-HORMONE AND INSULIN-STIMULATED SECRETION IN HYPERINSULINEMIC WOMEN WITH POLYCYSTIC OVARY DISEASE, Fertility and sterility, 64(4), 1995, pp. 703-708
Objective: To analyze the action of a long-acting somatostatin analogu
e on circulating insulin levels and on pituitary sensitivity to GnRH i
n women affected by polycystic ovary disease (PCOD). Design: Controlle
d clinical study. Setting: Normal human volunteers in the Department o
f Obstetrics and Gynecology, Universita' Cattolica del Sacro Cuore. Pa
tients: Twenty euglycemic women affected by PCOD, aged 19 to 30 years,
were studied in their early follicular phase. Interventions: A long-a
cting somatostatin analogue (octreotide) was administered SC for 6 wee
ks; an oral glucose tolerance test (OGTT), a GnRH test, and plasma hor
mone determinations were performed at baseline and repeated after 6 we
eks of treatment. A glucose load also was performed after 1 week of tr
eatment. Main Outcome Measures: Insulin and glucose serum concentratio
ns were measured in all samples under the oral glucose stimulus, LH an
d 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 nor
moinsulinemic (n = 8). Octreotide administration did not affect the gl
ycemic 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-stimulat
ed secretion in a group of polycystic ovary patients. Octreotide may b
e useful in normalizing these alterations and in reducing ovarian andr
ogen secretion of hyperinsulinemic subjects.