The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin and ghrelin in polycystic ovary syndrome.

OBJECTIVE: To evaluate short-term leptin and ghrelin concentrations in women with polycystic ovary syndrome (PCOS) who use low-dose oral contraceptives containing drospirenone. DESIGN: Prospective study. SETTING: Department of obstetrics and gynaecology in a university hospital. PATIENT(S): Twenty women with PCOS were enrolled in the study. INTERVENTION(S): A low-dose oral contraceptive containing ethinyl estradiol and drospirenone was given for three cycles. MAIN OUTCOME MEASURE(S): Serum androstenedione, free T, T, dehydroepiandrosterone sulphate, sex hormone-binding globulin, FSH, LH, E(2), lipid profiles, leptin, and ghrelin levels were measured in each subject. Insulin resistance was estimated by the homeostasis model assessment-insulin resistance (HOMA-IR). RESULT(S): While leptin concentrations did not change with therapy, ghrelin levels increased statistically. Baseline leptin concentrations were correlated positively with body mass index, waist-to-hip ratio, insulin, and HOMA-IR and negatively with ghrelin. After controlling for body mass index and waist-to-hip ratio in a partial correlation analysis, leptin levels were not correlated with these parameters. Ghrelin was inversely correlated with body mass index, waist-to-hip ratio, insulin, HOMA-IR, and free T. CONCLUSION(S): In patients with PCOS, an oral contraceptive containing ethinyl estradiol and drospirenone increases ghrelin levels but not leptin levels in a 3-month period. Ghrelin might be related to the metabolic and androgenic changes in patients with PCOS.

Plasma adrenomedullin levels in patients with polycystic ovary syndrome.

OBJECTIVE: To evaluate adrenomedullin levels in patients with polycystic ovary syndrome (PCOS). DESIGN: Prospective study. SETTING: Department of obstetrics and gynecology in a university hospital. PATIENT(S): Thirty-eight women with PCOS and 29 healthy control subjects were enrolled in the study. INTERVENTION(S): Plasma adrenomedullin, serum androstenedione, free T, T, DHEAS, SHBG, thyrotropin, PRL, FSH, LH, and E2 were measured in each subject. Insulin resistance was estimated by fasting insulin level, fasting glucose:insulin ratio and 75-g glucose tolerance test for 2 hours. MAIN OUTCOME MEASURE(S): Plasma adrenomedullin levels and correlations among adrenomedullin and gonadotropins, female sex steroids, androgens, and insulin resistance. RESULT(S): There was no significant difference concerning plasma adrenomedullin concentrations between the groups. In patients with PCOS, fasting glucose, fasting insulin, body mass index, and free T were inversely correlated with the plasma adrenomedullin. Plasma adrenomedullin was significantly correlated with glucose:insulin ratio. After controlling for body mass index, there were no significant correlations between the above-mentioned parameters. CONCLUSION(S): Adrenomedullin may play a role in regulating the insulin metabolism in patients with PCOS.