Discontinuous low-dose flutamide-metformin plus an oral or a transdermal contraceptive in patients with hyperinsulinaemic hyperandrogenism:: normalizing effects on CRP, TNF-α and the neutrophil/lymphocyte ratio
Discontinuous low-dose flutamide-metformin plus an oral or a transdermal contraceptive in patients with hyperinsulinaemic hyperandrogenism:: normalizing effects on CRP, TNF-α and the neutrophil/lymphocyte ratio
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DOI：
10.1093/humrep/dei329
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发表时间：
2006-02-01
影响因子：
6.1
通讯作者：
de Zegher, F
中科院分区：
文献类型：
--
作者：
Ibáñez, L;Valls, C;de Zegher, F
背景：低剂量氟脲-二甲双胍（Flu-Met）联合口服避孕药是高胰岛素血症性高雄激素症女性的一种治疗选择。我们质疑(1)如果不连续给药，Flu-Met是否能保持疗效；（ii）非连续性甲流酰胺加透皮避孕药与甲流酰胺加口服避孕药的疗效比较；以及（iii）这些治疗是否也会降低循环c反应蛋白（CRP）和肿瘤坏死因子（tnf - α），以及中性粒细胞/淋巴细胞的高比率。方法：非肥胖、患有高胰岛素血症性高雄性激素症的年轻患者（n = 31）开始使用Flu-Met（21/28天），并随机接受6个月的口服避孕药或透皮避孕药。结果：Flu-Met与口服或透皮避孕药联合使用的效果相似。在两组中，CRP和tnf - α水平下降，高中性粒细胞/淋巴细胞比率正常化（P < 0.001）。两组的瘦体重都增加了（P < 0.001），但与之前连续使用Flu-Met相比，两组的脂肪量都没有减少。结论：如果每28天只给药21天，flui - met似乎不太具有脂溶性。当与口服避孕药或透皮避孕药联合使用时，Flu-Met的疗效相当。流感- met的影响范围可能包括CRP和tnf - α水平降低，中性粒细胞/淋巴细胞比例正常化。
BACKGROUND: Low-dose flutamide-metformin (Flu-Met) with an oral contraceptive is a therapeutic option for women with hyperinsulinaemic hyperandrogenism. We questioned (i) whether Flu-Met maintains efficacy if given discontinuously; (ii) how the efficacy of discontinuous Flu-Met plus a transdermal contraceptive compares with Flu-Met plus oral contraceptive; and (iii) whether these treatments also lower circulating C-reactive protein (CRP) and tumour necrosis factor alpha (TNF-alpha) and the high neutrophil/lymphocyte ratio. METHODS: Non-obese, young patients (n = 31) with hyperinsulinaemic hyperandrogenism were started on Flu-Met (21/28 days) and randomized to receive in addition either a drospirenone oral contraceptive or a transdermal contraceptive for 6 months. RESULTS: The effects of Flu-Met were similar whether combined with oral or transdermal contraceptive. In both groups, CRP and TNF-alpha levels fell and the high neutrophil/lymphocyte ratio normalized (P < 0.001). Lean body mass increased (P < 0.001) in both groups but, in contrast to earlier experience with continuous Flu-Met, fat mass failed to decrease in either group. CONCLUSIONS: Flu-Met seems less lipolytic, if given for only 21 days in every 28-day period. The efficacy of Flu-Met is comparable when combined with an oral contraceptive or a transdermal contraceptive. The range of Flu-Met effects may henceforth include lower levels of CRP and TNF-alpha, and a normalization of the neutrophil/lymphocyte ratio.