Cited by 21Ovarian function and disordersAdipokines, Inflammation, and Metabolic DiseasesAcne and Rosacea Treatments and Effects

Ethinyl Estradiol-Cyproterone Acetate Versus Low-Dose Pioglitazone-Flutamide-Metformin for Adolescent Girls with Androgen Excess: Divergent Effects on CD163,TWEAK Receptor,ANGPTL4, and LEPTIN Expression in Subcutaneous Adipose Tissue

Díaz, Marta, Chacón, Matilde R., López-Bermejo, Abel, Maymó-Masip, Elsa, Salvador, Cristina, Vendrell, Joan, de Zegher, Francis, Ibáñez, Lourdes·2012·The Journal of Clinical Endocrinology & Metabolism

Abstract

OBJECTIVE: The aim was to compare the effects of a traditional therapy (an oral estroprogestagen) to those of a novel treatment (a low-dose combination of generics) in adolescent girls with androgen excess. STUDY DESIGN AND METHODS: In an open-label trial over 1 yr, 34 adolescents (age, 16 yr; body mass index, 23 kg/m2) with hyperinsulinemic androgen excess and without pregnancy risk were randomized to receive daily ethinyl estradiol-cyproterone acetate (EE-CA; Diane 35 Diario) or a low-dose combination of pioglitazone 7.5 mg/d, flutamide 62.5 mg/d, and metformin 850 mg/d (PioFluMet). Markers of androgen excess, C-reactive protein, high molecular weight adiponectin, lipids, carotid intima media thickness, body composition (absorptiometry), abdominal fat partitioning (magnetic resonance imaging), and gene expression in longitudinal biopsies of sc adipose tissue at the abdominal level (RT-PCR) were assessed at baseline and after 1 yr. RESULTS: EE-CA and low-dose PioFluMet reduced androgen excess comparably, but had divergent effects on C-reactive protein, high molecular weight adiponectin, lipids, carotid intima media thickness, lean mass, abdominal and visceral fat, and on the expression of CD163, leptin, TNF-like weak inducer of apoptosis receptor, and angiopoietin-like protein 4, respectively, related to macrophage activation, fat accretion, inflammation, and lipoprotein metabolism in adipose tissue. All these divergences pointed to a healthier condition on low-dose PioFluMet. CONCLUSION: EE-CA and PioFluMet are similarly effective in reversing androgen excess over 1 yr, but low-dose PioFluMet is superior in reversing inflammatory, metabolic, and cardiovascular anomalies that are often associated with androgen excess.

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Crossref · 10.1210/jc.2012-1754

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  • Intervention trials in adolescents with polycystic ovary syndrome have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance.

    “These trials have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance [148-160]”

    From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [150]

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Authors
Díaz, M., Chacón, M. R., López-Bermejo, A., Maymó-Masip, E., Salvador, C., Vendrell, J., de Zegher, F., & Ibáñez, L.
Affiliations
  • Hospital Sant Joan de Déu Barcelona (ES)
  • Instituto de Salud Carlos III (ES)
Corresponding author
Ibáñez, Lourdes
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2012-10
Volume
97
Issue
10
Pages
3630-3638
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2011658030
Cited by
21
References
39
Citations by year
2025: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 2 · 2015: 3 · 2013: 3
FWCI
2.23
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
Keywords
hyperandrogenism, adolescent girls, CD163, ANGPTL4, leptin, macrophage activation, adipose tissue inflammation, abdominal fat, carotid intima-media thickness, cardiovascular risk, C-reactive protein, adiponectin
MeSH terms
TWEAK Receptor, Angiopoietin-Like Protein 4, Pioglitazone, CD163 Antigen, Adolescent, Androgen Antagonists, Body Composition, Dose-Response Relationship, Drug, Drug Combinations, Ethinyl Estradiol, Female, Flutamide, Humans, Hypoglycemic Agents, Metformin, Receptors, Cell Surface, Antigens, Differentiation, Myelomonocytic, Antigens, CD, Gene Expression, Cyproterone Acetate, Hyperandrogenism, Receptors, Tumor Necrosis Factor, Leptin, Angiopoietins, Thiazolidinediones, Subcutaneous Fat, Abdominal Fat

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