Low-Dose Spironolactone-Pioglitazone-Metformin Normalizes Circulating Fetuin-A Concentrations in Adolescent Girls with Polycystic Ovary Syndrome

Table 1

Data from adolescent girls with polycystic ovary syndrome (PCOS) who were randomized to receive either ethinylestradiol-levonorgestrel (EE-LNG; ) or low-dose spironolactone-pioglitazone-metformin (SPIOMET; ) for 12 months.

	Controls ()	All PCOS ()	EE-LNG ()			SPIOMET ()
		Baseline^a	Baseline	12 months	Δ 0−12 months	Baseline	12 months	Δ 0−12 months
Age (year)	15.6 ± 0.2	15.8 ± 0.2	15.9 ± 0.3	—	—	15.7 ± 0.3	—	—
BMI (kg/m^2)	22.2 ± 0.5	23.6 ± 0.5	23.9 ± 0.8	24.0 ± 0.8	0.04 ± 0.27	23.1 ± 0.7	23.0 ± 0.7	−0.31 ± 0.20
SBP (mmHg)	112 ± 2	114 ± 1	115 ± 2	112 ± 3	−3.2 ± 2.9	113 ± 2	109 ± 1^b	−4.9 ± 2.2
DBP (mmHg)	70 ± 1	71 ± 1	72 ± 2	75 ± 2	3.7 ± 2.9	70 ± 1	70 ± 1	−0.5 ± 1.6
AST (UI/L)	17.8 ± 0.7	16.0 ± 0.5	15.7 ± 0.7	16.5 ± 1.1	0.8 ± 0.7	16.3 ± 0.9	17.3 ± 1.0	0.8 ± 0.9
ALT (UI/L)	15.0 ± 1.1	14.2 ± 0.8	15.1 ± 1.3	18.9 ± 2.3^b	3.9 ± 1.7	13.2 ± 0.6	15.4 ± 1.5	1.7 ± 1.2
GGT (UI/L)	13.9 ± 1.4	12.3 ± 0.4	12.3 ± 0.7	16.4 ± 1.0^d,i	4.1 ± 0.9	12.2 ± 0.6	10.9 ± 0.4	−1.1 ± 0.6^g
CRP (nmol/L)	7.5 ± 1.5	15.3 ± 2.3	14.5 ± 2.3	28.5 ± 5.9^b,i	14 ± 6.6	16.1 ± 4.2	5.5 ± 0.8^c	−10.6 ± 3.7^f
N/L ratio	1.6 ± 0.1	1.8 ± 0.1	1.9 ± 0.2	1.8 ± 0.3	−0.1 ± 0.4	1.8 ± 0.1	1.6 ± 0.2	−0.2 ± 0.1
Glucose (mmol/L)	5.1 ± 0.1	4.7 ± 0.1	4.7 ± 0.1	4.5 ± 0.1^b	−0.2 ± 0.1	4.6 ± 0.1	4.3 ± 0.1^c	−0.3 ± 0.1
Insulin (pmol/L)	56 ± 6	80 ± 7	92 ± 12	110 ± 18^h	18 ± 13	70 ± 7	44 ± 7^c	−27 ± 7^g
HOMA-IR	1.9 ± 0.2	2.3 ± 0.1	2.5 ± 0.2	2.5 ± 0.3^i	0.2 ± 0.4	2.1 ± 0.2	1.2 ± 0.2^c	−0.8 ± 0.2^e
HDL-C (mmol/L)	1.44 ± 0.04	1.31 ± 0.04	1.34 ± 0.05	1.35 ± 0.06	0.02 ± 0.05	1.28 ± 0.05	1.40 ± 0.07	0.12 ± 0.06
LDL-C (mmol/L)	2.26 ± 0.11	2.31 ± 0.09	2.31 ± 0.13	2.62 ± 0.19	0.31 ± 0.15	2.30 ± 0.12	2.32 ± 0.10	0.01 ± 0.07
Triglycerides (mmol/L)	0.63 ± 0.05	0.63 ± 0.04	0.60 ± 0.06	0.62 ± 0.04	0.02 ± 0.05	0.66 ± 0.07	0.56 ± 0.05	−0.10 ± 0.05
Testosterone (nmol/L)	0.97 ± 0.05	2.01 ± 0.10	2.14 ± 0.19	0.09 ± 0.08^d	−1.23 ± 0.17	1.89 ± 0.08	0.96 ± 0.08^d	−0.93 ± 0.09
SHBG (nmol/L)	58 ± 4	29 ± 2	30 ± 3	63 ± 7^d,i	33 ± 6	28 ± 2	32 ± 3	3 ± 3^g
Fetuin-A (g/L)	1.18 ± 0.05	0.92 ± 0.03	0.93 ± 0.04	0.94 ± 0.04^h	0.01 ± 0.07	0.92 ± 0.05	1.13 ± 0.05^c	0.23 ± 0.07^e
Subcutaneus fat (cm^2)^†	98 ± 12	150 ± 13	149 ± 18	142 ± 18	−7.8 ± 9.9	150 ± 19	142 ± 18	−7.8 ± 7.6
Visceral fat (cm^2)^†	32 ± 2	46 ± 3	43 ± 4	42 ± 5	−1.3 ± 3.6	49 ± 5	33 ± 2^b	−16 ± 5.4^e
Hepatic fat (%)^†	12.6 ± 1.4	16.7 ± 1.0	17.0 ± 1.4	19.8 ± 1.4^i	2.8 ± 1.4	16.5 ± 1.4	10.1 ± 0.9^c	−6.4 ± 1.0^g

Values are . BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; CRP: c-reactive protein; N/L: neutrophile-to-lymphocyte ratio; HOMA-IR: homeostatic model assessment-insulin resistance; HMW: adiponectin, high molecular weight; TC: total cholesterol; TG, triglycerides; SHBG: sex hormone binding globulin; D4-A: 4-androstenedione; DHEAS: dehydroisoandrosterone sulphate. ^†By MRI; , , and between controls and PCOS girls at baseline. ^aNo significant differences between randomized PCOS subgroups at baseline; ^b, ^c, and ^d within subgroups for 0-to-12-month changes (Δ); ^e, ^f, and ^g between subgroups for 0-to-12-month changes (Δ); ^h and ⁱ between subgroups at 12 months.