High neutrophil count in girls and women with hyperinsulinaemic hyperandrogenism: normalization with metformin and flutamide overcomes the aggravation by oral contraception
Por:
Ibañez-Toda L, Jaramillo AM, Ferrer A and de Zegher F
Publicada:
1 sep 2005
Resumen:
BACKGROUND: The endocrine hallmark of polycystic ovary syndrome (PCOS) is hyperinsulinaemic hyperandrogenism; another facet of PCOS is low-grade inflammation. METHODS: In adolescents and young women with hyperinsulinaemic hyperandrogenism (n = 118; mean age 16 years, body mass index 22 kg/m(2)), we analysed whether the PCOS-associated rise in leukocyte count is already detectable at young age and, if so, whether such elevation is lowered by metformin, flutamide-metformin, oral contraception (OC), or their combination. RESULTS: Leukocyte count ( x 1000/mm(3)) in patients was high versus controls (7.5 +/- 0.1 versus 6.4 +/- 0.1; P < 0.001) due to a rise in neutrophils (4.2 +/- 0.1 versus 3.0 +/- 0.1; P < 0.001). Randomized studies at mean ages of 12.5 years (n = 24) and 15.2 years (n = 33) demonstrated normalizing effects of metformin (850 mg/day; P < 0.001) and, respectively, metformin plus flutamide (62.5 mg/day) on neutrophil counts; in young women (18.3 years; n = 41), the neutrophil count rose further on OC monotherapy (P = 0.003), but normalized on the same OC plus flutamide-metformin (P < 0.001 versus OC alone). CONCLUSIONS: (i) A high leukocyte count is already present in girls with hyperinsulinaemic hyperandrogenism, and this is due to a raised neutrophil count; (ii) this hyperneutrophilia is attenuated by metformin or flutamide-metformin, and is amplified by OC monotherapy; (iii) if these treatments are combined, the normalizing effect of flutamide-metformin overcomes the OC effect on neutrophil count.
Filiaciones:
Ibañez-Toda L:
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain.
Jaramillo AM:
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain.
Ferrer A:
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain.
de Zegher F:
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Spain.
Univ Barcelona, Endocrinol Unit, Hosp St Joan Deu, Barcelona 08950, Spain
Katholieke Univ Leuven, Dept Pediat, Louvain, Belgium
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