Results
BMI-matched-healthy, PCOS
INSULIN RESISTANCE, ANDROGEN EXCESS
Both PioFluMet and SPIOMET reduced androgen excess within 6 months towards normal, similarly to EE-CA or EE-LNG. However, only treatment with PioFluMet or SPIOMET -but not with OCs- reduced both the hepatic fat excess and insulin resistance (Data from adolescent girls with androgen excess who were randomized to receive ethinylestradiol-cyproteroneacetate [EE-CA (N=17)], low-dose pioglitazone-flutamide-metformin [PioFluMet (N=17)], ethinylestradiol-levonorgestrel [EE-LNG(N=20)] or low-dose spironolactone-pioglitazone-metformin [SPIOMET (N=18)] for 6 months, and from age and BMI-matched-healthy control girls (N=28).Values are mean ± SEM. MRI, magnetic resonance imaging; BMI, bone mineral density; SHBG, sex hormone-binding globulin; FAI, free androgen index; HOMA-IR, homeostasis model assessment insulin resistance; HMW, high-molecular weight.


Pre-treatment follistatin levels were similar in girls with PCOS and in controls (0.7 ± 0.1 ng/mL in both subgroups). OCs significantly raised serum follistatin after 6 months; this increase was higher with EE-CA than with EE-LNG (6.8-fold vs 2.5-fold At baseline, circulating follistatin correlated negatively with HMW-adiponectin (r=-0.316, p=0.009) and positively with mean insulin levels during an oral glucose tolerance test (OGTT; r= 0.303, p= 0.012) [Bivariate correlations between circulating follistatin and, respectively, HMW-adiponectin and mean insulin concentration during an oral glucose tolerance test at baseline [panels 