Low-Dose Spironolactone-Pioglitazone-Metformin Normalizes Circulating Fetuin-A Concentrations in Adolescent Girls with Polycystic Ovary Syndrome
Por:
Díaz-Silva M, Gallego-Escuredo JM, López-Bermejo A, de Zegher F, Villarroya-Gombau F and Ibañez-Toda L
Publicada:
1 ene 2018
Ahead of Print:
19 jul 2018
Resumen:
Background. Fetuin-A is a glycoprotein produced in the liver and related to metabolic syndrome; fetuin-A secretion is divergently regulated in different pathological conditions. In girls with polycystic ovary syndrome (PCOS), insulin sensitization results in a more favorable endocrine-metabolic outcome than oral contraception; we assessed whether those differences are underscored by changes in circulating fetuin-A. Methods. Fetuin-A concentration endocrine-metabolic markers and hepatovisceral fat were measured longitudinally in 35 PCOS girls [age, 16 yr; body mass index (BMI), 23 kg/m(2)] randomized to receive either oral contraception [ethinylestradiol-levonorgestrel (n = 18)] or a low-dose combination of spironolactone, pioglitazone, and metformin (SPIOMET, n = 17) over 12 months. Healthy adolescent girls (age- and BMI-matched) were used as controls (n = 25). Results. Pretreatment fetuin-A serum levels in PCOS girls were lower than those in controls. After 12 months on treatment, fetuin-A raised to control levels only in the SPIOMET subgroup (P = 0.009, versus oral contraception); this increase was paralleled by a healthier metabolic profile with less hepatic fat (by MRI); baseline serum fetuin-A as well as the changes over 12 months was inversely related to hepatic adiposity. Conclusions. A low-dose combination of insulin sensitizers and an antiandrogen-but not oral contraception-normalizes fetuin-A levels in adolescent girls with PCOS.
Filiaciones:
Díaz-Silva M:
Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
Gallego-Escuredo JM:
Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
Institut de Recerca Biomèdica de Lleida, Lleida, Spain
López-Bermejo A:
Department of Pediatrics, Dr. Josep Trueta Hospital, Girona Institute for Biomedical Research, 17007 Girona, Spain
de Zegher F:
Department of Development and Regeneration, University of Leuven, Leuven, Belgium
Villarroya-Gombau F:
Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
Ibañez-Toda L:
Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
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