Sensitization to insulin induces ovulation in nonobese adolescents with anovulatory hyperandrogenism

Citation
L. Ibanez et al., Sensitization to insulin induces ovulation in nonobese adolescents with anovulatory hyperandrogenism, J CLIN END, 86(8), 2001, pp. 3595-3598
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Endocrynology, Metabolism & Nutrition","Endocrinology, Nutrition & Metabolism
Journal title
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
ISSN journal
0021-972X → ACNP
Volume
86
Issue
8
Year of publication
2001
Pages
3595 - 3598
Database
ISI
SICI code
0021-972X(200108)86:8<3595:STIIOI>2.0.ZU;2-U
Abstract
In nonobese girls with an adolescent variant of polycystic ovary syndrome, insulin-sensitizing treatment reduces hyperinsulinism, dyslipidemia, and hy perandrogenism and restores eumenorrhea; however, the effect on anovulation is unknown. We assessed whether metformin treatment is capable of inducing ovulation in nonobese adolescents with anovulatory hyperandrogenism after precocious pubarche. The study population consisted of 18 adolescents (mean age, 16 yr; body mas s index, 21.4 kg/m(2); 3-7 yr beyond menarche) with hyperinsulinemic hypera ndrogenism. All girls received metformin for 6 months in a daily dose of 12 75 mg. Before inclusion, persistent anovulation was documented by weekly se rum progesterone measurements less than 4 ng/ml (months -3 and -1); the ovu lation rate was assessed similarly after 2,4 and 6 months on metformin; a p remenstrual progesterone level greater than 8 ng/ml was used as ovulation m arker. Regular menses were reported by 16 of 18 girls within 4 months on metformin , and all girls were eumenorrheic after 6 months on metformin. Of the 18 gi rls, 1 (6%) ovulated after 2 months on metformin, 7 (39%) after 4 months, a nd 14 (78%) after 6 months; ovulation induction failed in the girls with th e lowest birth weight or most severe hyperandrogenism. Metformin treatment was well tolerated. In conclusion, sensitization to insulin was found to be an effective approa ch to induce ovulation in nonobese adolescents with anovulatory hyperandrog enism.