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Horm Metab Res 2020; 52(02): 89-94
DOI: 10.1055/a-1084-5441
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Differential Impact of Insulin Sensitizers vs. Anti-Androgen on Serum Leptin Levels in Vitamin D Replete PCOS Women: A Six Month Open Labeled Randomized Study

Aafia Rashid
1   Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Mohd Ashraf Ganie
1   Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Imtiyaz Ahmad Wani
1   Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Gulzar Ahmad Bhat
1   Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Feroz Shaheen
2   Department of Radio-Diagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Ishfaq Ahmed Wani
1   Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
,
Mukesh Shrivastava
3   Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
,
Zaffar Amin Shah
4   Department of Immunology & Molecular Medicine, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
› Author Affiliations Funding details This research was performed independently of any funding as part of institutional activities of the investigators and researchers.
Further Information

Publication History

received 18 September 2019

accepted 11 December 2019

Publication Date:
13 February 2020 (online)

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Abstract

Women with PCOS are linked to insulin resistance, inflammation, and vitamin D (VD) deficiency. The study endeavors to comprehend the differential impact of insulin sensitizers vs. anti-androgen on serum leptin levels among women with PCOS rendered vitamin D replete with high VD oral supplement. This was open-labeled randomized study that screened 180 eligible women presenting to Endocrine clinic with oligomenorrhea or features of hyperandrogenism. Ninety-nine women who furnished written informed consent and fulfilled the Rotterdam 2003 criteria for diagnosis of PCOS were randomized into 3 drug treatment arms to receive either spironolactone (50 mg/d; n=30), metformin (1000 mg/d; n=30) or pioglitazone (30 mg/d; n=30). These women were also administered oral VD (4000 IU/day) in addition to the allocated drug for a period of 6 months. Detailed history, clinical examination, and laboratory evaluation was carried out at baseline and 6 months after intervention. Number of menstrual cycles/year increased while as Ferriman–Gallwey score, blood glucose, HOMA-IR, and plasma insulin levels significantly decreased in all the three arms with better outcomes in spironolactone and pioglitazone arms (p<0.05). Similarly, serum leptin levels superiorly improved in spironolactone and pioglitazone group. Pioglitazone group showed better efficacy in lowering serum total testosterone (p<0.05). Co-supplementation of high dosage VD with spironolactone or pioglitazone are more effective in reducing plasma leptin levels than metformin, and thus might prove to be better therapeutic strategies for women with PCOS.

Key words

polycystic ovary syndrome - hyperandrogenism - insulin resistance - inflammation serum leptin
 

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