The Effect of Dipeptidyl Peptidase 4 Inhibition on Growth Hormone Secretion in Women With Polycystic Ovarian Syndrome

Inclusion Criteria:

* Females, age 18-40 years
* BMI ≥ 30 kg/m2
* Diagnosis of polycystic ovary syndrome defined by 2003 Rotterdam criteria as meeting two out of the three below criteria :

  * Oligomenorrhea or amenorrhea
  * clinical or biochemical evidence of hyperandrogenism (hirsutism and/or documented upper normal or elevated serum testosterone in the absence of exogenous hormone therapy or Metformin)
  * documented history of polycystic ovaries on ultrasound examination

Exclusion Criteria:

* Smoking
* Type 1 or Type 2 Diabetes Mellitus, as defined by a fasting glucose of 126 mg/dL or greater at the time of screening visit or the use of anti-diabetic medication
* Hypertension, as defined by an untreated seated systolic blood pressure (SBP) greater than 150 mmHg and/or an untreated diastolic blood pressure (DBP) greater than 95 mmHg at the time of screening visit or the use of anti-hypertensive medication
* History of reported or recorded hypoglycemia (plasma glucose \< 70 mg/dL)
* Pregnancy and/or Breast-Feeding (Negative serum pregnancy test will be confirmed at screening visit and every study visit.)
* Surgical menopause, defined as s/p total hysterectomy including bilateral salpingo-oophorectomy
* Use of transdermal or oral contraceptive therapy. The use of these contraceptives must be discontinued at least 8 weeks prior to study initiation.
* The use of insulin sensitizers, specifically Metformin or thiazolidinediones must be discontinued 8 weeks prior to study initiation.
* Anemia defined as hematocrit \<35% at screening visit
* Cardiovascular or cerebrovascular disease, including history of myocardial infarction, history of congestive heart failure, history of stroke
* Pulmonary Hypertension
* Abnormal thyroid hormone levels (TSH), prolactin, or morning 17 hydroxyprogesterone at the time of screening visit
* Impaired renal function, defined as estimated glomerular filtration rate (eGFR) \<60
* Impaired hepatic function (AST or ALT \> 2 X upper limit of normal range)
* Treatment with an investigational drug in the 1 month preceding the study
* Allergy to any of the medications used in this protocol
* Regular work of a night-shift or unusual schedule which may disrupt circadian rhythm.
* Personal or Family History (defined as first degree relative) of Pancreatic Cancer
* Personal history of Pancreatitis or known pancreatic lesions
* Coagulopathy as defined by history
* Regular NSAID use, including but not limited to, naproxen, ibuprofen, and aspirin
* Mental conditions rendering the subject unable to understand the nature, scope, and possible consequences of the study
* Inability to comply with the protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study
* Any underlying or acute disease requiring regular medication that could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult