18507
document
Flutamide-metformin plus ethinylestradiol-drospirenone for lipolysis and antiatherogenesis in young women with ovarian hyperandrogenism : the key role of early , low-dose flutamide . A low-dose combination of flutamide-metformin and ethinylestradiol-drospirenone was recently found to reduce the excess of total and abdominal fat , to diminish the deficit in lean mass , and to attenuate the dysadipocytokinemia of young women with ovarian hyperandrogenism , a variant of polycystic ovary syndrome . We questioned the need to give flutamide , an androgen receptor blocker , together with an oral contraceptive that contains drospirenone , a progestin claimed to have antiandrogen properties . The additive effects of low-dose flutamide ( 62.5 mg/d ) were assessed over 3 months in young patients with hyperinsulinemic ovarian hyperandrogenism ( n = 40 ; age , approximately 17 yr ; body mass index , approximately 22 kg/m ( 2 ) ) ; all participants started on metformin ( 850 mg/d ) and a fourth-generation contraceptive ( ethinylestradiol 30 microg plus drospirenone 3 mg , 21 d/month ) , and they were randomized to receive flutamide in addition ( n = 20 ) or not ( n = 20 ) . Fasting blood glucose , serum insulin , lipid profile , testosterone , adiponectin , and IL-6 were determined at baseline and after 3 months , together with body composition ( by dual x-ray absorptiometry ) and with Doppler assessment of ovarian arterial resistance . At start , the pulsatility and resistance indices of ovarian arteries were elevated . By comparison of 3-month changes between randomized subgroups , the addition of low-dose flutamide was found to have consistently ( more ) normalizing effects on low-density lipoprotein cholesterol , IL-6 , and adiponectin , lean body mass , total and abdominal fat mass , and arterial flow in the ovaries . In conclusion , low-dose flutamide is herewith identified as a pivotal component within a first contraceptive combination therapy that has been shown to attenuate the hypoadiponectinemia , ovarian vascular hyperresistance , lean mass deficit , and central adiposity of young women with polycystic ovary syndrome . Finally , these data challenge any claim that drospirenone , as currently used in a contraceptive , is a clinically significant antiandrogen .
18508
Intervention_Pharmacological
flutamide-metformin
18509
Intervention_Pharmacological
ethinylestradiol-drospirenone
18510
Intervention_Pharmacological
drospirenone
18511
Intervention_Pharmacological
low-dose flutamide
18512
Intervention_Pharmacological
metformin
18513
Intervention_Pharmacological
ethinylestradiol 30 microg plus drospirenone 3 mg , 21 d/month
18514
Intervention_Pharmacological
flutamide
18515
Intervention_Pharmacological
flutamide
18516
Intervention_Pharmacological
drospirenone
18517
Outcome_Physical
lipolysis and antiatherogenesis
18518
Outcome_Physical
excess of total and abdominal fat
18519
Outcome_Physical
lean mass
18520
Outcome_Physical
dysadipocytokinemia
18521
Outcome_Physical
Fasting blood glucose
18522
Outcome_Physical
serum insulin
18523
Outcome_Physical
lipid profile
18524
Outcome_Physical
testosterone
18525
Outcome_Physical
adiponectin
18526
Outcome_Physical
IL-6
18527
Outcome_Other
pulsatility
18528
Outcome_Other
resistance indices
18529
Outcome_Physical
low-density lipoprotein cholesterol , IL-6
18530
Outcome_Physical
adiponectin , lean body mass
18531
Outcome_Physical
total and abdominal fat mass
18532
Outcome_Physical
arterial flow in the ovaries
18533
Outcome_Physical
hypoadiponectinemia
18534
Outcome_Physical
ovarian vascular hyperresistance
18535
Outcome_Physical
lean mass deficit
18536
Outcome_Physical
central adiposity
18537
Participant_Age
young
18538
Participant_Sex
women
18539
Participant_Condition
ovarian hyperandrogenism
18540
Participant_Age
young
18541
Participant_Sex
women
18542
Participant_Condition
ovarian hyperandrogenism
18543
Participant_Condition
variant of polycystic ovary syndrome
18544
Participant_Age
17 yr