The effects of short-term medroxyprogesterone acetate and micronized progresterone on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome: A prospective randomized study
The effects of short-term medroxyprogesterone acetate and micronized progresterone on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome: A prospective randomized study
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DOI：
10.1210/jc.2002-020294
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发表时间：
2002-10-01
影响因子：
5.8
通讯作者：
Haydardedeoglu, B
中科院分区：
文献类型：
--
作者：
Bagis, T;Gokcel, A;Haydardedeoglu, B
在这项前瞻性、随机研究中，我们测定了口服或阴道注射醋酸甲羟孕酮（MPA）和微孕酮（MP）对多囊卵巢综合征（PCOS）患者激素参数、葡萄糖代谢和脂质谱的10天影响。连续28名多囊卵巢综合征女性随机接受10天MPA、口服MP或阴道MP治疗。观察各组治疗前后的激素参数、胰岛素水平、口服糖耐量试验、血脂、稳态模型评估及胰岛素敏感性定量检查指标。口服MPA和NIP可降低LH （15.64 +/- 13.17 ~ 7.27 +/- 4.35 IU/l, P = 0.028; 18.85 +/- 11.86 ~ 10.49 +/- 6.48 IU/l, P = 0.009）和总睾酮（5.85 +/- 2.80 ~ 3.40 +/- 1.72 nmol/l, P = 0.013; 5.29 +/- 2.98 ~ 3.43 +/- 2.10 nmol/l, P = 0.037）水平。激素参数未随阴道MP而改变。口服MPA组基础胰岛素（123.42 +/- 97.50 ~ 87.38 +/- 48.68 pmol/l, P = 0.021）和稳态模型评价水平降低，胰岛素敏感性定量检查指标显著升高。低密度脂蛋白胆固醇和脂蛋白(a)水平仅在MPA组下降。结论：短期口服MP，尤其是口服MPA可改善PCOS患者的胰岛素敏感性。阴道MP对糖代谢和脂质谱无影响。黄体生成素、总睾酮和胰岛素水平可能受到短期黄体酮治疗的影响。
In this prospective, randomized study we determined 10-d effects of medroxyprogesterone acetate (MPA) and micronized progesterone (MP) either orally or per vaginally on hormonal parameters, glucose metabolism and lipid profiles in patients with polycystic ovary syndrome (PCOS). Twenty-eight consecutive women with PCOS were randomized to receive 10-d MPA, oral MP, or vaginal MP. Hormonal parameters, insulin levels, oral glucose tolerance test, lipid profiles, and homeostasis model assessment and quantitative insulin sensitivity check indexes were assessed in all groups before and after treatment. Oral MPA and oral NIP decreased LH (15.64 +/- 13.17 to 7.27 +/- 4.35 IU/liter, P = 0.028, and 18.85 +/- 11.86 to 10.49 +/- 6.48 IU/liter, P = 0.009, respectively) and total testosterone (5.85 +/- 2.80 to 3.40 +/- 1.72 nmol/liter, P = 0.013, and 5.29 +/- 2.98 to 3.43 +/- 2.10 nmol/liter, P = 0.037, respectively) levels. Hormonal parameters did not change with vaginal MP. Basal insulin (123.42 +/- 97.50 to 87.38 +/- 48.68 pmol/liter; P = 0.021) and homeostasis model assessment levels decreased, and quantitative insulin sensitivity check index increased significantly in the oral MPA group. Low density lipoprotein cholesterol and lipoprotein (a) levels decreased only in the MPA group. In conclusion, short-term oral MP and especially oral MPA might ameliorate insulin sensitivity in patients with PCOS. Vaginal MP has no effect on glucose metabolism and lipid profiles. LH, total testosterone, and insulin levels may be affected from the short-term progesterone treatment.