Polycystic Ovary Syndrome Clinical Trial
Official title:
Determination if Pharmacologic Blockade of Androgen Action Decreases Renal Clearance of D-Chiro-Inositol (DCI), Increases the Circulating Concentration of DCI, and Enhances Insulin-Stimulated Release of the D-chiro-inositol-containing Inositolphosphoglycan (DCI-IPG) Mediator in Obese Women With Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is the major cause of infertility in the United States. Many women with PCOS demonstrate insulin resistance and a compensatory hyperinsulinemia.This is due to both an intrinsic form of insulin resistance unique to PCOS and, in many cases, acquired insulin resistance due to obesity. The importance of this observation lies in the fact that hyperinsulinemia appears to play an important pathogenetic role in the hyperandrogenism and anovulation of both obese and lean women with PCOS.
Hyperinsulinemia stimulates ovarian production of androgens, especially testosterone, in
PCOS. Therefore, it is theoretically possible that testosterone increases urinary clearance
of D-chiro-inositol (uCl(DCI) in PCOS, and that this serves as the explanation for the
correlation between uClDCI and insulin sensitivity. While we regard this possibility as
unlikely, it is important that it be tested. To accomplish this, we will assess obese (Body
Mass Index (BMI) >30 kg/m2) women with and without PCOS at baseline, and again after 4 weeks
of androgen action blockade with the drug flutamide. Flutamide is an antiandrogen that works
by blocking the binding of androgens to the androgen receptor.
We will determine if this pharmacologic blockade i) decreases the renal clearance of DCI,
ii) increases the circulating concentration of DCi, and iii) enhances the insulin-stimulated
release of the D-chiro-inositol-containing inositolphosphoglycan (DCI-IPG) mediator during
an OGTT.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Health Services Research
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