Disparate effects of pharmacotherapy on plasma plasminogen activator inhibitor-1 levels in women with the polycystic ovary syndrome

作者：Koiou Ekaterini; Tziomalos Konstantinos^*; Katsikis Ilias; Delkos Dimitrios; Tsourdi Elena A; Panidis Dimitrios

来源：Hormones-International Journal of Endocrinology and Metabolism, 2013, 12(4): 559-566.

DOI：10.14310/horm.2002.1444

• Hyperandrogenemia
• Insulin resistance
• Metformin
• Orlistat
• Plasminogen activator inhibitor-1
• Polycystic ovary syndrome
• Sibutramine
• Weight loss

OBJECTIVE: Polycystic ovary syndrome (PCOS) is characterized by obesity and insulin resistance (IR), which result in elevated plasminogen activator inhibitor-1 (PAI-1) levels. We aimed to assess the changes in PAI-1 levels in PCOS during treatment with metformin and during weight loss. DESIGN: Twenty-three normal weight women with PCOS were given metformin 850 mg bid for 6 months. Fifty overweight/obese women with PCOS were prescribed an energy-restricted diet, were instructed to exercise and were randomized to orlistat 120 mg tid or sibutramine 10 mg qd for 6 months. RESULTS: In normal weight women, treatment with metformin reduced the body mass index (BMI) and circulating androgens, improved markers of IR and lowered PAI-1 levels. In overweight/obese women, sibutramine and orlistat yielded comparable reductions in BMI and markers of IR. In contrast, the effects on the free androgen index (FAI) differed (p=0.027): sibutramine reduced the FAI (p=0.005), whereas orlistat had no effect. The effects of sibutramine and orlistat on PAI-1 levels also differed (p=0.042): sibutramine reduced PAI-1 levels (p%26lt;0.001), whereas orlistat had no effect. CONCLUSIONS: Metformin and sibutramine, but not orlistat, reduce PAI-1 levels in PCOS. The reduction in circulating androgens during metformin and sibutramine treatment might be implicated in this decline.

• 出版日期2013-12