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Impact of Metformin and Rosiglitazone Treatment on GLUT4 mRNA Expression in Women with Polycystic Ovary Syndrome

M Jensterle, Endocrinology, University Medical Centre, Ljubljana, 1525, Slovenia
A Janez, Endocrinology, University Medical Centre, Ljubljana, Slovenia
B Mlinar, Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
J Marc, Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
J Prezelj, Endocrinology, University Medical Centre, Ljubljana, Slovenia
M Pfeifer, Endocrinology, University Medical Centre, Ljubljana, Slovenia

Correspondence: Mojca Jensterle, Email: mojcajensterle{at}yahoo.com

Abstract

Objective: The insulin resistant state of the polycystic ovary syndrome (PCOS) was found to be associated with a decreased glucose transporter GLUT4 expression in the insulin target tissues. This study was performed to explore whether the well-known clinical, hormonal and metabolic efficacy of metformin or rosiglitazone treatment is reflected in the modulation of adipocyte GLUT 4 mRNA expression in patients with PCOS.

Methods: We enrolled 35 women with PCOS. They received either metformin or rosiglitazone for 6 months. History, blood samples for measurement of androgens and subcutaneous adipose tissue samples were taken at baseline and at endpoint. Quantification of GLUT4 mRNA expression in adipose tissue was performed by real-time quantitative PCR. Homeostasis model assessment (HOMAIR) score calculation was applied as a measure for insulin resistance (IR).

Results: GLUT 4 mRNA expression in adipose tissue increased significantly in both groups (p<0.001). The increase was more pronounced in the rosiglitazone (ROSI) group (p=0.040). There was a statistically significant improvement of HOMAIR in both groups (p=0.008). After treatment, frequencies of menstrual bleeding were significantly higher (p<0.001) and serum total testosterone levels significantly lower in both groups (p=0.001).

Conclusions: A six-month therapy with insulin sensitizers resulted in marked improvement in adipose tissue GLUT 4 mRNA expression in PCOS patients, rosiglitazone being more effective as compared to metformin. The augmentation of the insulin signal transduction was accompanied by a significant improvement of HOMAIR , menstrual pattern and androgen profile.