In PCOS patients the addition of low-dose spironolactone induces a more marked reduction of clinical and biochemical hyperandrogenism than metformin alone

Nutrition, Metabolism and Cardiovascular Diseases

Volumn 24, Issue 2, 2014, Pages 132-139

  Mazza, A ^a   Fruci, B ^a   Guzzi, P ^a   D'Orrico, B ^a   Malaguarnera, R ^a   Veltri, P ^a   Fava, A ^a   Belfiore, A ^a  

^a UNIVERSITY MAGNA GRAECIA OF CATANZARO   (Italy)

Author keywords

Hirsutism; Insulin resistance; Metformin; Obesity; PCOS; Spironolactone

Indexed keywords

ANDROSTENEDIONE; METFORMIN; SPIRONOLACTONE; TESTOSTERONE;

ADULT; ARTICLE; BODY MASS; CHOLESTEROL BLOOD LEVEL; DRUG SAFETY; DRUG TOLERABILITY; FEMALE; GLUCOSE BLOOD LEVEL; HIRSUTISM; HUMAN; HYPERANDROGENISM; INSULIN RESISTANCE; LOW CALORY DIET; LOW DRUG DOSE; MAJOR CLINICAL STUDY; METABOLIC SYNDROME X; OVARY INSUFFICIENCY; OVARY POLYCYSTIC DISEASE; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; ROUTINE ASSESSMENT OF PATIENT INDEX DATA; TRIACYLGLYCEROL BLOOD LEVEL; WAIST CIRCUMFERENCE;

HIRSUTISM; INSULIN RESISTANCE; METFORMIN; OBESITY; PCOS; SPIRONOLACTONE;

ADULT; ANDROSTENEDIONE; DEHYDROEPIANDROSTERONE; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; HIRSUTISM; HUMANS; HYPERANDROGENISM; HYPOGLYCEMIC AGENTS; INSULIN RESISTANCE; METFORMIN; POLYCYSTIC OVARY SYNDROME; SPIRONOLACTONE; TESTOSTERONE; YOUNG ADULT;

EID: 84894230996     PISSN: 09394753     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.numecd.2013.04.016     Document Type: Article

References (30)

1. March W.A., Moore V.M., Willson K.J., Phillips D.I., Norman R.J., Davies M.J. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010 Feb, 25(2):544-551. [Research Support, Non-U.S. Gov't].
2. Palomba S., Falbo A., Zullo F., Orio F. Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review. Endocr Rev 2009 Feb, 30(1):1-50. [Review].
3. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan, 81(1):19-25. [Guideline Research Support, Non-U.S. Gov't].
4. Azziz R., Hincapie L.A., Knochenhauer E.S., Dewailly D., Fox L., Boots L.R. Screening for 21-hydroxylase-deficient nonclassic adrenal hyperplasia among hyperandrogenic women: a prospective study. Fertil Steril 1999 Nov, 72(5):915-925. [Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.].
5. Hatch R., Rosenfield R.L., Kim M.H., Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 1981 Aug 1, 140(7):815-830. [Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.].
6. Alberti K.G., Eckel R.H., Grundy S.M., Zimmet P.Z., Cleeman J.I., Donato K.A., et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009 Oct 20, 120(16):1640-1645. [Consensus Development Conference Practice Guideline Research Support, Non-U.S. Gov't].
7. Mathur R.S., Moody L.O., Landgrebe S., Williamson H.O. Plasma androgens and sex hormone-binding globulin in the evaluation of hirsute females. Fertil Steril 1981 Jan, 35(1):29-35.
8. Matthews D.R., Hosker J.P., Rudenski A.S., Naylor B.A., Treacher D.F., Turner R.C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985 Jul, 28(7):412-419. [Comparative Study Research Support, Non-U.S. Gov't].
9. Amato M.C., Giordano C., Galia M., Criscimanna A., Vitabile S., Midiri M., et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010 Apr, 33(4):920-922.
10. Ehrmann D.A., Liljenquist D.R., Kasza K., Azziz R., Legro R.S., Ghazzi M.N. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006 Jan, 91(1):48-53. [Multicenter Study Research Support, N.I.H., Extramural].
11. Amato M.C., Verghi M., Galluzzo A., Giordano C. The oligomenorrhoic phenotypes of polycystic ovary syndrome are characterized by a high visceral adiposity index: a likely condition of cardiometabolic risk. Hum Reprod 2011 Jun, 26(6):1486-1494. [Research Support, Non-U.S. Gov't].
12. Cosma M., Swiglo B.A., Flynn D.N., Kurtz D.M., Labella M.L., Mullan R.J., et al. Clinical review: insulin sensitizers for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab 2008 Apr, 93(4):1135-1142. [Meta-Analysis Research Support, Non-U.S. Gov't Review].
13. Lord J.M., Flight I.H., Norman R.J. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ 2003 Oct 25, 327(7421):951-953. [Meta-Analysis Research Support, Non-U.S. Gov't Review].
14. Kashyap S., Wells G.A., Rosenwaks Z. Insulin-sensitizing agents as primary therapy for patients with polycystic ovarian syndrome. Hum Reprod 2004 Nov, 19(11):2474-2483. [Meta-Analysis].
15. Ladson G., Dodson W.C., Sweet S.D., Archibong A.E., Kunselman A.R., Demers L.M., et al. The effects of metformin with lifestyle therapy in polycystic ovary syndrome: a randomized double-blind study. Fertil Steril 2011 Mar 1, 95(3):1059-1066. e1-7 [Comparative Study Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural].
16. Hoeger K.M., Kochman L., Wixom N., Craig K., Miller R.K., Guzick D.S. A randomized, 48-week, placebo-controlled trial of intensive lifestyle modification and/or metformin therapy in overweight women with polycystic ovary syndrome: a pilot study. Fertil Steril 2004 Aug, 82(2):421-429. [Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.].
17. Lord J., Thomas R., Fox B., Acharya U., Wilkin T. The effect of metformin on fat distribution and the metabolic syndrome in women with polycystic ovary syndrome - a randomised, double-blind, placebo-controlled trial. BJOG 2006 Jul, 113(7):817-824. [Randomized Controlled Trial].
18. Eisenhardt S., Schwarzmann N., Henschel V., Germeyer A., von Wolff M., Hamann A., et al. Early effects of metformin in women with polycystic ovary syndrome: a prospective randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab 2006 Mar, 91(3):946-952. [Randomized Controlled Trial].
19. Otta C.F., Wior M., Iraci G.S., Kaplan R., Torres D., Gaido M.I., et al. Clinical, metabolic, and endocrine parameters in response tometformin and lifestyle intervention in women with polycystic ovary syndrome: a randomized, double-blind, and placebo control trial. Gynecol Endocrinol 2010 Mar, 26(3):173-178. [Randomized Controlled Trial Research Support, N.I.H., Extramural].
20. Tang T., Glanville J., Orsi N., Barth J.H., Balen A.H. The use of metformin for women with PCOS undergoing IVF treatment. Hum Reprod 2006 Jun, 21(6):1416-1425. [Randomized Controlled Trial].
21. Pasquali R., Gambineri A., Biscotti D., Vicennati V., Gagliardi L., Colitta D., et al. Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome. J Clin Endocrinol Metab 2000 Aug, 85(8):2767-2774. [Clinical Trial Comparative Study Randomized Controlled Trial].
22. Christy N.A., Franks A.S., Cross L.B. Spironolactone for hirsutism in polycystic ovary syndrome. Ann Pharmacother 2005 Sep, 39(9):1517-1521. [Review].
23. Kebapcilar L., Taner C.E., Kebapcilar A.G., Alacacioglu A., Sari I. Comparison of four different treatment regimens on coagulation parameters, hormonal and metabolic changes in women with polycystic ovary syndrome. Arch Gynecol Obstet 2009, Mar 28.
24. Brown J., Farquhar C., Lee O., Toomath R., Jepson R.G. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database Syst Rev 2009, 2:CD000194. [Meta-Analysis Review].
25. Farquhar C., Lee O., Toomath R., Jepson R. Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. Cochrane Database Syst Rev 2003, 4:CD000194. [Review].
26. Ganie M.A., Khurana M.L., Eunice M., Gupta N., Gulati M., Dwivedi S.N., et al. Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study. J Clin Endocrinol Metab 2004 Jun, 89(6):2756-2762. [Clinical Trial Comparative Study Randomized Controlled Trial].
27. Karakurt F., Sahin I., Guler S., Demirbas B., Culha C., Serter R., et al. Comparison of the clinical efficacy of flutamide and spironolactone plus ethinyloestradiol/cyproterone acetate in the treatment of hirsutism: a randomised controlled study. Adv Ther 2008 Apr, 25(4):321-328. [Randomized Controlled Trial].
28. Brown J., Farquhar C., Beck J., Boothroyd C., Hughes E. Clomiphene and anti-oestrogens for ovulation induction in PCOS. Cochrane Database Syst Rev 2009, 4:CD002249. [Meta-Analysis Review].
29. Moghetti P., Tosi F., Tosti A., Negri C., Misciali C., Perrone F., et al. Comparison of spironolactone, flutamide, and finasteride efficacy in the treatment of hirsutism: a randomized, double blind, placebo-controlled trial. J Clin Endocrinol Metab 2000 Jan, 85(1):89-94. [Case Reports Clinical Trial Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't].
30. McLellan A.R., Rentoul J., MacKie R., McInnes G.T. Lack of effect of spironolactone on hair shaft diameter in hirsute females. Postgrad Med J 1989 Jul, 65(765):459-462. [Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't].