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대한생식의학회지 제32권 제2호 2010년
다낭성난소증후군 환자에서 Pioglitazone이 인슐린 민감도, 난소 기능, 난소 기질 내 혈류에 미치는 영향
울산대학교 의과대학 서울아산병원 산부인과학교실1, 제주대학교 의과대학 산부인과2
이향아1,, 이향아1,김정훈1,최정원1,박선정1,이수정1,최은선1,김성훈1,채희동1,손영수2,강병문1
Effects of Pioglitazone on Insulin Sensitivity, Ovarian Function and Intraovarian Stromal Blood Flow in Women with Polycystic Ovary Syndrome
Hyang Ah Lee1, Chung Hoon Kim1, Jeong Won Choi1, Sun Jung Park1, Soo Jeong Lee1, Eun Sun Choi1, Sung Hoon Kim1, Hee Dong Chae1, Young Soo Son2, Byung Moon Kang1
1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea, 2Department of Obstetrics and Gynecology, College of Medicine, Cheju University, Jeju, Korea
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Objective: This study was performed to investigate the effects of pioglitazone, an insulin sensitizing agent, on insulin resistance, ovarian function and intraovarian stromal blood flow in patients with polycystic ovarian syndrome (PCOS). Material and Methods: Thirty patients with PCOS, aged 18~34 years, were recruited. Criteria for diagnosis of PCOS were as defined in 2003 Rotterdam consensus. They were treated for 6 months with pioglitazone at a dose of 30 mg/day orally. The hormonal blood profile, fasting serum glucose levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and an ovarian stromal artery (OSA) blood flow were assessed at baseline and after 6 months of treatment. Results: Eighteen (60.0%) of 30 patients treated with pioglitazone demonstrated a spontaneous ovulation After pioglitazone treatment, fasting insulin concentrations, serum glucose levels after 75 g OGTT significantly decreased (p=0.001, p=0.04, respectively), and fasting glucose to insulin (G/I) ratio significantly increased (p<0.001). The pioglitazone treatment induced a significant reduction in serum LH, testosterone (T) and free T levels (p<0.001, p=0.02, p=0.002, respectively). The resistance index (RI) values of OSA significantly increased after treatment (p<0.001). In analyzing pioglitazone-treated patients according to their body mass index (BMI), nonobese group as well as obese group showed a significant improvement in fasting G/I ratio (p<0.01). The pioglitazone treatment induced a significant reduction in serum LH and free T levels in nonobese group (p<0.001, p<0.05, respectively) as well as obese group (p=0.001, p<0.05, respectively). The RI values of OSA significantly increased in both nonobese and obese groups after pioglitazone treatment (p<0.001, p=0.003, respectively). Conclusions: Pioglitazone could ameliorate the glycoinsulinemic metabolism, and this beneficialeffects of this drug could improve the endocrine-reproductive condition associated with the decrease of ovarian stromal artery blood flow, in both nonobese and obese patients with PCOS.
키워드 : Pioglitazone, Polycystic ovary syndrome (PCOS), Insulin resistance, Intraovarian stromal blood flow
교신저자 : chkim@amc.seoul.kr
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