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- Title
Effects of Oral Contraception and Lifestyle Modification on Incretins and TGF-ß Superfamily Hormones in PCOS.
- Authors
Shah, Aesha; Dodson, William C; Kris-Etherton, Penny M; Kunselman, Allen R; Stetter, Christy M; Gnatuk, Carol L; Estes, Stephanie J; Allison, Kelly C; Sarwer, David B; Sluss, Patrick M; Coutifaris, Christos; Dokras, Anuja; Legro, Richard S
- Abstract
<bold>Objective: </bold>To examine the effects of common treatments for polycystic ovary syndrome (PCOS) on a panel of hormones (reproductive/metabolic).<bold>Design: </bold>Secondary analysis of blood from a randomized controlled trial of three 16-week preconception interventions designed to improve PCOS-related abnormalities: continuous oral contraceptive pills (OCPs, N = 34 subjects), intensive lifestyle modification (Lifestyle, N = 31), or a combination of both (Combined, N = 29).<bold>Materials and Methods: </bold>Post-treatment levels of activin A and B, inhibin B, and follistatin (FST), as well as Insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 2 (IGFBP-2), glucagon, glucagon-like peptide 1 (GLP-1) and 2, and oxyntomodulin were compared to baseline, and the change from baseline in these parameters were correlated with outcomes.<bold>Results: </bold>Oral contraceptive pill use was associated with a significant suppression in activin A, inhibin A, and anti-mullerian hormone (AMH), but a significant increase in FST. IGF-1, IGFBP-2, glucagon, and GLP-2 levels were significantly decreased. Oxyntomodulin was profoundly suppressed by OCPs (ratio of geometric means: 0.09, 95% confidence interval [CI]: 0.05, 0.18, P < 0.001). None of the analytes were significantly affected by Lifestyle, whereas the effects of Combined were similar to OCPs alone, although attenuated. Oxyntomodulin was significantly positively associated with the change in total ovarian volume (rs = 0.27; 95% CI: 0.03, 0.48; P = 0.03) and insulin sensitivity index (rs = 0.48; 95% CI: 0.27, 0.64; P < 0.001), and it was inversely correlated with change in area under the curve (AUC) glucose [rs = -0.38; 95% CI: -0.57, -0.16; P = 0.001]. None of the hormonal changes were associated with live birth, only Activin A was associated with ovulation (risk ratio per 1 ng/mL increase in change in Activin A: 6.0 [2.2, 16.2]; P < 0.001).<bold>Conclusions: </bold>In women with PCOS, OCPs (and not Lifestyle) affect a wide variety of reproductive/metabolic hormones, but their treatment response does not correlate with live birth.
- Subjects
UNITED States; INSULIN-like growth factor-binding proteins; OVULATION; INDUCED ovulation; SOMATOMEDIN C; GLUCAGON-like peptide 1; INSULIN sensitivity; INCRETINS; VAGINAL contraceptives; OBESITY complications; POLYCYSTIC ovary syndrome treatment; OBESITY treatment; OBESITY; LIFESTYLES; RESEARCH; HORMONES; POLYCYSTIC ovary syndrome; GROWTH factors; RESEARCH methodology; BEHAVIOR therapy; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; TREATMENT effectiveness; COMPARATIVE studies; RANDOMIZED controlled trials; ORAL contraceptives; RESEARCH funding; COMBINED modality therapy; PHARMACODYNAMICS; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 1, p108
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa682