Session: SAT 532-553-Hyperandrogenic Disorders
Poster Board SAT-547
Aim: To compare on- and post-treatment effects of intervention with an oral contraceptive versus an insulin-sensitizing treatment for androgen excess in non-obese adolescents.
Design: Randomized, open-label trial.
Study Population: Non-obese adolescent girls with hyperinsulinemic androgen excess and without risk of pregnancy (mean age 16 yr, BMI 23 kg/m2, N=34).
Interventions: Ethinylestradiol-cyproteroneacetate (EE-CA) versus a low-dose combination of pioglitazone (7.5 mg/d), flutamide (62.5 mg/d) and metformin (850 mg/d) (PioFluMet) for 18 mo; post-treatment follow-up for 6 mo.
Main Outcomes: Androgen excess (hirsutism and acne scores; serum testosterone); glucose-stimulated insulinemia; circulating C-Reactive Protein (CRP); carotid intima media thickness (cIMT); body composition (absorptiometry); abdominal fat partitioning (magnetic resonance imaging); menstrual regularity.
Results: EE-CA and PioFluMet attenuated androgen excess similarly but had opposing effects – still discernible 6 mo post-treatment – on glucose-induced insulinemia, CRP, cIMT, visceral adiposity, lean mass and menstrual regularity, all these differences pointing to a healthier condition on/after PioFluMet.
Conclusion: The on- and post-treatment effects of PioFluMet compared favourably to those of oral contraception with EE-CA in non-obese adolescents with androgen excess. The intervention whereby androgen excess is reduced in adolescence influences the post-treatment phenotype. PioFluMet-like interventions in adolescence may thus hold the potential to prevent part of the androgen-excess phenotype in adulthood, including adiposity and subfertility.
Nothing to Disclose: LI, MD, GS, MVM, AL, FED
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