Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments
PurposeFollistatin is a glycoprotein that represses members of the transforming growth factor-β superfamily including activin. Higher follistatin levels have been associated with an increased risk for type 2 diabetes and with polycystic ovary syndrome (PCOS). In non-obese adolescent girls with PCOS,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1125569/full |
| _version_ | 1811168260900519936 |
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| author | Marta Díaz Marta Díaz Francis de Zegher Lourdes Ibáñez Lourdes Ibáñez |
| author_facet | Marta Díaz Marta Díaz Francis de Zegher Lourdes Ibáñez Lourdes Ibáñez |
| author_sort | Marta Díaz |
| collection | DOAJ |
| description | PurposeFollistatin is a glycoprotein that represses members of the transforming growth factor-β superfamily including activin. Higher follistatin levels have been associated with an increased risk for type 2 diabetes and with polycystic ovary syndrome (PCOS). In non-obese adolescent girls with PCOS, insulin sensitization results in a healthier endocrine-metabolic outcome than oral contraception (OC); we assessed whether those differences are underscored by changes in serum follistatin concentrations.MethodsCirculating follistatin, endocrine-metabolic markers and hepato-visceral fat were measured longitudinally in 72 girls with PCOS [age, 16 years; body mass index (BMI), 23 Kg/m2] randomized to receive PioFluMet [pioglitazone (7.5 mg/d), metformin (850 mg/d) and flutamide (62.5 mg/d), n=17]; EE-CA [an OC containing 35 µg ethinylestradiol (EE) and 2 mg cyproterone acetate (CA), n=17]; SPIOMET [Spironolactone (50 mg/d), pioglitazone (7.5 mg/d) and metformin (850 mg/d), n=18], or EE-LNG [an OC containing 20 µg EE and 100 mg levonorgestrel (LNG), n=20]. Twenty-eight age- and BMI-matched healthy girls served as controls.ResultsPre-treatment follistatin levels were similar in PCOS and controls. OCs raised serum follistatin after 6 months (6.8-fold vs 2.5-fold for EE-CA and EE-LNG, respectively). Neither SPIOMET nor PioFluMet changed follistatin levels. Follistatin correlated negatively with high-molecular weight adiponectin and positively with mean serum insulin concentrations during an oral glucose tolerance test at baseline, and with liver fat after 6 months.ConclusionIn girls with PCOS, follistatin levels rise significantly after 6 months on OCs and this increase associates to a worsening of markers of insulin resistance and to changes in liver fat. |
| first_indexed | 2024-04-10T16:23:07Z |
| format | Article |
| id | doaj.art-0abe88c77cf042ecb0688c5c4c21f896 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-10T16:23:07Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-0abe88c77cf042ecb0688c5c4c21f8962023-02-09T09:03:12ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-02-011410.3389/fendo.2023.11255691125569Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatmentsMarta Díaz0Marta Díaz1Francis de Zegher2Lourdes Ibáñez3Lourdes Ibáñez4Endocrinology Department, Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, SpainUniversity of Leuven, Leuven, BelgiumEndocrinology Department, Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, SpainCentro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, SpainPurposeFollistatin is a glycoprotein that represses members of the transforming growth factor-β superfamily including activin. Higher follistatin levels have been associated with an increased risk for type 2 diabetes and with polycystic ovary syndrome (PCOS). In non-obese adolescent girls with PCOS, insulin sensitization results in a healthier endocrine-metabolic outcome than oral contraception (OC); we assessed whether those differences are underscored by changes in serum follistatin concentrations.MethodsCirculating follistatin, endocrine-metabolic markers and hepato-visceral fat were measured longitudinally in 72 girls with PCOS [age, 16 years; body mass index (BMI), 23 Kg/m2] randomized to receive PioFluMet [pioglitazone (7.5 mg/d), metformin (850 mg/d) and flutamide (62.5 mg/d), n=17]; EE-CA [an OC containing 35 µg ethinylestradiol (EE) and 2 mg cyproterone acetate (CA), n=17]; SPIOMET [Spironolactone (50 mg/d), pioglitazone (7.5 mg/d) and metformin (850 mg/d), n=18], or EE-LNG [an OC containing 20 µg EE and 100 mg levonorgestrel (LNG), n=20]. Twenty-eight age- and BMI-matched healthy girls served as controls.ResultsPre-treatment follistatin levels were similar in PCOS and controls. OCs raised serum follistatin after 6 months (6.8-fold vs 2.5-fold for EE-CA and EE-LNG, respectively). Neither SPIOMET nor PioFluMet changed follistatin levels. Follistatin correlated negatively with high-molecular weight adiponectin and positively with mean serum insulin concentrations during an oral glucose tolerance test at baseline, and with liver fat after 6 months.ConclusionIn girls with PCOS, follistatin levels rise significantly after 6 months on OCs and this increase associates to a worsening of markers of insulin resistance and to changes in liver fat.https://www.frontiersin.org/articles/10.3389/fendo.2023.1125569/fullfollistatinPCOShepato-visceral fatmetforminpioglitazonespironolactone |
| spellingShingle | Marta Díaz Marta Díaz Francis de Zegher Lourdes Ibáñez Lourdes Ibáñez Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments Frontiers in Endocrinology follistatin PCOS hepato-visceral fat metformin pioglitazone spironolactone |
| title | Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments |
| title_full | Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments |
| title_fullStr | Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments |
| title_full_unstemmed | Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments |
| title_short | Circulating follistatin concentrations in adolescent PCOS: Divergent effects of randomized treatments |
| title_sort | circulating follistatin concentrations in adolescent pcos divergent effects of randomized treatments |
| topic | follistatin PCOS hepato-visceral fat metformin pioglitazone spironolactone |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1125569/full |
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