Low Dose Growth Hormone in Obese PCOS Women

Study hypothesis: Growth hormone (GH), through its generation of free 'bioavailable' insulin-like growth factor (IGF)-I, can improve insulin sensitivity and the metabolic profile of women with polycystic ovary syndrome. Study aims: To determine the mechanism of how low dose GH treatment affects the body's sensitivity to insulin actions and whether this low GH dose can affect the body's handling of steroid hormone levels (cortisol clearance) and testosterone (male hormones) in obese women with polycystic ovary syndrome. Study design: Obese women with polycystic ovary syndrome, but not recently been on GH treatment, and presently attending Outpatients Clinic will be invited to participate in this study. The subjects will be assessed at the initial visit to ascertain their suitability before further participating in the study. If suitable, an equal number of women will be randomized to receive either daily low dose GH or placebo injections first for 12 weeks, before exchanging over for another 12 weeks of treatment after a 4-week washout period. Before, during and after treatment, the subjects will be assessed at frequently with blood tests, scans and fat biopsies. During the study, the subjects will be studied 4 times at the Oregon Clinical and Translational Research Institute (OCTRI). At the first, second and final visit, testing will include scans to measure the amount of whole body fat and fat in the stomach area, muscle, and liver; blood tests to measure levels of cortisol, and fat tissue (taken from a biopsy) analysis to measure the density of insulin-like growth factor-I (a hormone stimulated by growth hormone in the body) in fat; whereas blood tests to examine how well insulin works in the body (insulin sensitivity) will be collected at all visits of the study.

Sex

Female

Minimum age

21 Years

Maximum age

45 Years

Inclusion Criteria:

* Ability to provide written informed consent and comply with study assessments for the full duration of the study.
* Age 21 to 45 years
* Body mass index between 30 to 40 kg/m2
* Diagnosis of PCOS with underlying insulin resistance (assessed by HOMA at screening visit) and/or other features that characterizes the metabolic syndrome such as hypertension ( \> 130/85 mmHg), abdominal obesity (waist circumference \> 88 cm), and acanthosis nigricans
* Diagnosis of normal or impaired glucose tolerance (WHO criteria)
* Stable body weight for at least 6 months prior to study entry (body weight deviating +/- 5 kg from previously recorded weight \> 6 months ago)
* Normal thyroid, renal and hepatic function
* Able to self administer daily GH/Placebo injections

Exclusion Criteria:

* Inability to comply with study requirements
* Body mass index \< 30 kg/m2 and \> 40 kg/m2 (patients with body mass index \> 40 kg/m2 are excluded because they will not fit into the MRS scanner)
* Untreated hypothyroidism or hyperthyroidism
* Anemia from any cause
* Known diabetes mellitus
* Patients with an increased risk of venous thrombosis or previous history of recurrent venous thrombosis
* Patient on any insulin-sensitizers (e.g., Metformin, Rosiglitazone, Pioglitazone) within 30 days of screening assessment
* Patient on any anti-androgens (e.g., Spironolactone, Cyproterone acetate, Flutamide, Finasteride) within 30 days of screening assessment
* Patient with other concurrent illnesses
* Pregnant (positive pregnancy test) prior enrollment in the study or planning to conceive whilst participating in the study
* Emotional/social instability likely to prejudice study completion
* Previous history of known malignancy
* Recurrent or severe unexplained hypoglycemia
* Known or suspected drug/alcohol abuse
* Patient with any metals in the body
* Any other condition/s that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated
* Participation in another simultaneous medical investigation or trial

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