Effect of Thiazolidinedione Amide on Insulin Resistance, Creactive Protein and Endothelial Function in Young Women with Polycystic Ovary Syndrome

Purpose: To investigate the effect of thiazolidinedione amide (TZDA) treatment on high-sensitivity Creactive protein (hsCRP) levels and endothelial dysfunction in patients with polycystic ovary syndrome (PCOS).
Methods: Twenty five women (mean age 24.7 ± 3.9 years; mean body mass index (BMI), 23.2 ± 4.0 kg/m²) with PCOS were treated with 15 μM TZDA daily for 12 months. Serum levels of testosterone, leutenizing hormone (LH), follicle stimulating hormone (FSH), sex hormone-binding globulin (SHBG), insulin and hsCRP were measured. BMI, hirsutism scores and insulin sensitivity indices were also calculated prior to and after TZDA treatment. Brachial artery responses to stimuli was used to measure arterial endothelium and smooth muscle function prior to and after the treatment.
Results: TZDA treatment caused a significant (p < 0.05) decrease in serum testosterone from 93.1 ± 40.3 to 54.8 ± 19.5 ng/dl and fasting insulin concentration from 11.9 ± 6.8 to 9.23 ± 5.13 U/mL. Insulin resistance index significantly (p < 0.05) improved and hirsutism score decreased significantly from 11.6 ± 2.0 to 6.8 ± 2.0. BMI, waist circumference, serum total cholesterol, low-density lipoprotein (LDL)- cholesterol, FSH and LH levels remained almost unchanged. Twenty-four of the women reverted to regular menstrual cycles. SHBG levels showed a significant (p < 0.05) increase from 24.8 ± 9.5 to 49.1 ± 13.5 nmol/L after TZDA treatment. Serum hsCRP levels decreased (p < 0.05) from 0.25 ± 0.1 to 0.09 ± 0.02 mg/dL while endothelium-dependent vascular responses significantly improved (p < 0.05) following TZDA treatment (9.9 ± 3.9 vs 16.4 ± 5.1%).
Conclusion: TZDA treatment improves insulin sensitivity, decreases androgen production and improves endothelial dysfunction in young women with PCOS.

Keywords
Thiazolidinedione amide; Insulin sensitivity; Endothelial dysfunction; Polycystic ovary syndrome