REDUCTION OF ENDOGENOUS, OVARIAN AND ADRENAL ANDROGENS WITH KETOCONAZOLE DOES NOT ALTER INSULIN-RESPONSE IN THE POLYCYSTIC-OVARY-SYNDROME

Several different strategies were used to investigate the relationship between hyperandrogenism and hyperinsulinemia associated with polycys tic ovary syndrome. Ketoconazole was given orally (400 mg/day) for 9 m onths to evaluate the effect of reduction in ovarian and adrenal andro gens on insulin response (oral glucose tolerance test) in 35 women wit h polycystic ovary syndrome. Androgenic steroids (testosterone, andros tenedione, dehydroepiandrosterone sulphate, and free testosterone inde x) decreased (p<0.01), but basal insulinemia, maximum peak insulin, an d insulin/glucose ratio showed no significant changes. One month after treatment was stopped, free testosterone index, and serum concentrati ons of androstenedione and testosterone, increased (p<0.05), but no al terations were noted in insulin parameters. Body mass index was stable throughout the ten-month study period. Our findings suggest that endo genous androgens, no matter whether they are of ovarian or adrenal ori gin, do not play a major role in the modulation of hyperinsulinemia in patients with polycystic ovary syndrome.