The influence of combined oral contraceptives containing drospirenone on hypothalamic-pituitary-adrenocortical axis activity and glucocorticoid receptor expression and function in women with polycystic ovary syndrome
2015
Аутори:
Macut, DjuroBozic-Antic, Ivana
Brkljačić, Jelena
Topalovic, Vladanka
Macut, Jelica Bjekic
Panidis, Dimitrios
Kotlica, Biljana Kastratovic
Papadakis, Efstathios
Matić, Gordana
Vojnović-Milutinović, Danijela
Тип документа:
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт:
OBJECTIVE: Most women with PCOS have increased adrenal androgen
production, enhanced peripheral metabolism of cortisol and elevation in
urinary excretion of its metabolites. Increased cortisol clearance in
PCOS is followed by a compensatory overdrive of the
hypothalamic-pituitary-adrenocortical (HPA) axis. We hypothesized that
oral contraceptives containing ethinylestradiol and drospirenone
(EE-DRSP) could modulate glucocorticoid receptor (GR) expression and
function and thus affect HPA axis activity in PCOS patients. DESIGN: We
analyzed 12 women with PCOS (age 24.17 +/- 4.88 years; body mass index
22.05 +/- 3.97 kg/m(2)) treated for 12 months with EE-DRSP and 20 BMI
matched controls. In all subjects testosterone, dehydroepiandrosterone
sulfate (DHEAS), sex hormone binding globulin (SHBG), cortisol (basal
and after dexamethasone), concentrations of GR protein, phospo-GR211
protein, number of GR per cell (B-max) and its equilibrium dissociation
constant (K-D) were measured. RESULTS: Before treatment, increased
concentrations of testosterone and DHEAS (p<0.001, respectively),
unaltered basal cortisol and an increased sensitivity (p<0.05) of the
HPA axis to dexamethasone were observed in PCOS women in comparison to
controls. After treatment, testosterone (p<0.01), DHEAS (p<0.05) and
cortisol suppression after dexamethasone (p<0.01) were decreased in PCOS
women. There were no changes in GR protein concentration, GR
phosphorylation nor in the receptor functional parameters B-max and K-D
in women with PCOS before and after the therapy, and in comparison to
controls. CONCLUSIONS: Prolonged treatment with EE-DRSP in PCOS women
decreased serum androgens and increased cortisol in the presence of
decreased sensitivity of the HPA axis and did not exert changes in GR
expression and function.