Browsing by Author "Balint-Perić, L. (6701858516)"

This study was undertaken in order to evaluate the effect of an oral contraceptive containing 35 μg of ethinyl estradiol and 2 mg of cyproterone acetate (Diane-35) on carbohydrate and lipid metabolism in patients with polycystic ovary syndrome (PCOS). Twentythree patients with PCOS were treated with Diane-35 for between 9 and 18 cycles without interruption (a total of 318 treated cycles). Metabolic evaluations, which included measurements of fasting blood glucose, insulin, C-peptide, total cholesterol, triglyceride, total lipids, HDL-cholesterol, LDL-cholesterol and apolipoproteins (Apo A1, Apo A2 and Apo B), were performed before treatment and every 3rd cycle during the treatment period. In the case of 5 women an oral glucose tolerance test (oGTT) was performed before and after the 12th cycle of Diane-35 treatment, with blood samples taken for glucose, insulin and C-peptide measurements. Total cholesterol showed a significant increase after the 6th cycle (p < 0.001) and reached the mean maximal value after the 9th cycle. A similar increasing trend was observed with LDL-cholesterol, which also reached the maximal mean level after the 9th cycle of treatment (p < 0.05). There were no significant changes in HDL-cholesterol levels. Significant increases in serum triglyceride (p < 0.01) and total lipids (p < 0.001) were observed after the 3rd cycle. Apo A2 concentrations increased significantly after the 6th cycle (p < 0.001) and showed an increasing trend thereafter. A significant increase was also observed in Apo B concentrations after the 6th cycle but these decreased after the 12th cycle. In spite of these observed increases in serum lipids and lipoproteins, the mean levels remained within the normal range throughout the treatment period. Fasting serum glucose, insulin and C-peptide concentrations did not show any significant changes during the study. Higher insulin and C-peptide responses during the oGTT were observed after the 12th cycle but the differences in the areas under the curve before and after treatment were not significant. A deterioration of blood glucose was observed after treatment with Diane-35, a significant difference in mean values being noted 150 minutes after the glucose overload (p < 0.005). However, the areas under the curve in blood glucose response before (34.92 ± 4.12) and after (43.45 ± 3.61) treatment were not significantly different. The results of this study show that a low-dose estrogen-antiandrogen combination could cause deterioration of carbohydrate and lipid metabolism in PCO patients and strongly suggest a need for continuous monitoring of such patients having long-term estrogen-antiandrogen treatment. © 1990 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

This study was undertaken in order to evaluate the effect of an oral contraceptive containing 35 μg of ethinyl estradiol and 2 mg of cyproterone acetate (Diane-35) on carbohydrate and lipid metabolism in patients with polycystic ovary syndrome (PCOS). Twentythree patients with PCOS were treated with Diane-35 for between 9 and 18 cycles without interruption (a total of 318 treated cycles). Metabolic evaluations, which included measurements of fasting blood glucose, insulin, C-peptide, total cholesterol, triglyceride, total lipids, HDL-cholesterol, LDL-cholesterol and apolipoproteins (Apo A1, Apo A2 and Apo B), were performed before treatment and every 3rd cycle during the treatment period. In the case of 5 women an oral glucose tolerance test (oGTT) was performed before and after the 12th cycle of Diane-35 treatment, with blood samples taken for glucose, insulin and C-peptide measurements. Total cholesterol showed a significant increase after the 6th cycle (p < 0.001) and reached the mean maximal value after the 9th cycle. A similar increasing trend was observed with LDL-cholesterol, which also reached the maximal mean level after the 9th cycle of treatment (p < 0.05). There were no significant changes in HDL-cholesterol levels. Significant increases in serum triglyceride (p < 0.01) and total lipids (p < 0.001) were observed after the 3rd cycle. Apo A2 concentrations increased significantly after the 6th cycle (p < 0.001) and showed an increasing trend thereafter. A significant increase was also observed in Apo B concentrations after the 6th cycle but these decreased after the 12th cycle. In spite of these observed increases in serum lipids and lipoproteins, the mean levels remained within the normal range throughout the treatment period. Fasting serum glucose, insulin and C-peptide concentrations did not show any significant changes during the study. Higher insulin and C-peptide responses during the oGTT were observed after the 12th cycle but the differences in the areas under the curve before and after treatment were not significant. A deterioration of blood glucose was observed after treatment with Diane-35, a significant difference in mean values being noted 150 minutes after the glucose overload (p < 0.005). However, the areas under the curve in blood glucose response before (34.92 ± 4.12) and after (43.45 ± 3.61) treatment were not significantly different. The results of this study show that a low-dose estrogen-antiandrogen combination could cause deterioration of carbohydrate and lipid metabolism in PCO patients and strongly suggest a need for continuous monitoring of such patients having long-term estrogen-antiandrogen treatment. © 1990 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Hyperinsulinism accompanies the raised luteinising hormone (LH) concentrations in women with the polycystic ovary syndrome (PCOS). Somatostatin inhibits insulin and LH secretion in healthy adults, so the effect of treatment with a long-acting somatostatin analogue ('Sandostatin') on gonadotropin and androgen secretion in PCOS was investigated. LH pulsatility, androgen concentrations, and hormonal responses to an oral glucose load and to administration of a GnRH agonist (buserelin) were measured before and after 7 days' treatment with sandostatin 100 μg subcutaneously twice a day in 10 amenorrhoeic women with classic features of PCOS. Sandostatin significantly reduced integrated LH concentrations and LH pulse amplitudes, oestradiol, testosterone, and androstenedione concentrations, and LH responses to buserelin; it also suppressed insulin and C-peptide responses to an oral glucose load. Thus sandostatin inhibits pituitary and ovarian hormonal responses in part by a direct influence on pituitary activity, and the possibility of an indirect effect mediated by changes in insulin concentrations requires investigation. These findings have implications for the treatment of infertility in women with PCOS. © 1990.

In order to determine whether the inhibitory effect of octreotide on luteinizing hormone (LH) secretion and ovarian steroids observed in women with polycystic ovaries (PCO) is a direct or indirect action of the analog, we have investigated the effect of 7 days of octreotide on LH, follicle stimulating hormone (FSH) and ovarian steroids in nine insulin-dependent diabetic women without residual insulin secreting, as in these patients a possibly confusing inhibitory effect of octreotide on endogenous insulin production is excluded. LH and FSH pulsatility over 4 h and hormonal responses (LH, FSH, estradiol, testosterone and androstenedione) to a single subcutaneous injection of buserelin were measured before and after 7 days' treatment with octreotide 100 μg subcutaneously twice a day. Octreotide failed to induce a significant reduction in either serum gonadotropin or ovarian steroid levels, although there was a general tendency of hormonal responses to buserelin to be lower with the analog. The effect of octreotide on LH secretion seems to be in correlation with thepretreatment levels which are, in turn, at least determined partly by endogenous insulin secretion. Thus, the results of the present study support the view that insulin has an important influence on LH secretion. © 1992 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

In order to determine whether the inhibitory effect of octreotide on luteinizing hormone (LH) secretion and ovarian steroids observed in women with polycystic ovaries (PCO) is a direct or indirect action of the analog, we have investigated the effect of 7 days of octreotide on LH, follicle stimulating hormone (FSH) and ovarian steroids in nine insulin-dependent diabetic women without residual insulin secreting, as in these patients a possibly confusing inhibitory effect of octreotide on endogenous insulin production is excluded. LH and FSH pulsatility over 4 h and hormonal responses (LH, FSH, estradiol, testosterone and androstenedione) to a single subcutaneous injection of buserelin were measured before and after 7 days' treatment with octreotide 100 μg subcutaneously twice a day. Octreotide failed to induce a significant reduction in either serum gonadotropin or ovarian steroid levels, although there was a general tendency of hormonal responses to buserelin to be lower with the analog. The effect of octreotide on LH secretion seems to be in correlation with thepretreatment levels which are, in turn, at least determined partly by endogenous insulin secretion. Thus, the results of the present study support the view that insulin has an important influence on LH secretion. © 1992 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.