Effects of Pioglitazone on Insulin and Glucose Metabolism in Women With Polycystic Ovary Syndrome (PCOS)

This study has been terminated.
(Lack of recruitment)
Sponsor:
Information provided by (Responsible Party):
Virginia Commonwealth University
ClinicalTrials.gov Identifier:
NCT00868140
First received: March 22, 2009
Last updated: August 1, 2014
Last verified: August 2014
  Purpose

Our hypothesis is that hyperinsulinemia increases the renal clearance of D-chiro-inositol (DCI) in women with polycystic ovary syndrome (PCOS) and that this leads to a reduction in circulating insulin-stimulated DCI-IPG release. To assess the effects of a chronic reduction in circulating insulin on DCI metabolism, we propose to reduce circulating insulin in obese women with PCOS by improving insulin sensitivity with the drug pioglitazone. Pioglitazone is a thiazolidinedione that improves peripheral insulin sensitivity, presumably by activation of the PPARγ receptor.Administration of pioglitazone to women with PCOS has been shown to improve insulin sensitivity, reduce insulin secretion, and decrease both fasting and post-prandial serum insulin concentrations,


Condition Intervention
Polycystic Ovary Syndrome
Drug: pioglitazone
Drug: Placebo

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Health Services Research
Official Title: Determination if Indirectly Reducing Circulating Insulin by Improving Insulin Sensitivity With Pioglitazone, Decreases Renal Clearance of DCI, Increases the Circulating Concentration of DCI, and Enhances Insulin-stimulated Release of the DCI-IPG Mediator in Obese Women With PCOS

Resource links provided by NLM:


Further study details as provided by Virginia Commonwealth University:

Primary Outcome Measures:
  • DCI-IPG and DCI measurements in blood and urine [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Measurement of sex steroids [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Enrollment: 36
Study Start Date: February 2009
Study Completion Date: August 2011
Primary Completion Date: June 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Pioglitazone
Drug: pioglitazone
pioglitazone 45 mg
Placebo Comparator: 2
control to arm 1
Drug: Placebo
placebo daily

Detailed Description:

This protocol focuses on the hypothesis that a deficiency in a putative inositolphosphoglycan (IPG) mediator of insulin action, namely a D-chiro-inositol-containing IPG (DCI-IPG), contributes to the insulin resistance of some women with PCOS. Our interest in this area stems directly from our previous studies, which demonstrated that administration of the precursor, D-chiro-inositol (DCI), to both obese23 and lean24 women with PCOS improved glucose intolerance while reducing circulating insulin, and simultaneously improved ovulatory function and decreased serum androgens. These findings were recently confirmed in a large-scale study by an independent group.25 The findings of these three studies suggested that administration of DCI improved insulin sensitivity in PCOS, which then resulted in an improved hormonal and metabolic milieu.

  Eligibility

Ages Eligible for Study:   18 Years to 40 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Obese (BMI greater than or equal to 30 kg/m2) women with PCOS between 18-40 years of age:

    • oligomenorrhea (less than 8 menstrual periods annually)
    • biochemical hyperandrogenemia (elevated total or free testosterone)
    • normal thyroid function tests and serum prolactin; AND
    • exclusion of 21a-hydroxylase deficiency by a fasting 17a-hydroxyprogesterone less than 200 ng/dl.51,
  2. acceptable health on the basis of interview, medical history, physical examination, and laboratory tests (CBC, SMA20, urinalysis, negative pregnancy test).
  3. Signed, witnessed informed consent.
  4. Ability to comply with study requirements.

Exclusion Criteria:

  1. Diabetes mellitus by fasting glucose or OGTT, or clinically significant pulmonary, cardiac, renal, hepatic, neurologic, psychiatric, infectious, neoplastic and malignant disease (other than non-melanoma skin cancer).
  2. Current use of oral contraceptives.
  3. Documented or suspected recent (within one year) history of drug abuse or alcoholism.
  4. Ingestion of any investigational drug within two months prior to study onset.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00868140

Locations
United States, Virginia
Virginia Commonwealth University General Clinical Research Center
Richmond, Virginia, United States, 23298
Venezuela
Hospital de Clinical Caracas
Caracas, Venezuela, 1071
Sponsors and Collaborators
Virginia Commonwealth University
Investigators
Principal Investigator: John E. Nestler, M.D. Virginia Commonwealth University
  More Information

No publications provided

Responsible Party: Virginia Commonwealth University
ClinicalTrials.gov Identifier: NCT00868140     History of Changes
Other Study ID Numbers: VCUIRB4480, GCRC0824
Study First Received: March 22, 2009
Last Updated: August 1, 2014
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Syndrome
Polycystic Ovary Syndrome
Disease
Pathologic Processes
Ovarian Cysts
Cysts
Neoplasms
Ovarian Diseases
Adnexal Diseases
Genital Diseases, Female
Gonadal Disorders
Endocrine System Diseases
Pioglitazone
Hypoglycemic Agents
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 30, 2014