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An insulin nasal spray could help with polycystic ovary syndrome.


WOMEN with polycystic ovary syndrome often struggle to maintaina steady weight. A nasal spray of insulin might help such women burn calories, according to preliminary research in sheep, which can show many of the same symptoms of PCOS. A trial in women with the conditionis now being planned.
Around 7 to 8 per cent of women have polycystic ovary syndrome, which affects the way ovaries work.Women with PCOS often have irregular periods and can find it difficult to become pregnant. But PCOS also appears to put women at risk of obesity and diabetes. In the US, around three-quarters of women with PCOS are also obese. Colin Duncan at the University of Edinburgh, UK, says that most of his patients can have restored ovulation with the right treatment, but treating obesity is much harder. That is because women with PCOS find it more difficult to lose weight.

A study published inthe 1990s suggested that this is because women with PCOS are less able to burn calories. After most people eat a meal,their fat tissue starts to burn through calories, releasing heat, but this is reduced by around 25 per centin women with PCOS.
This means that awoman with PCOS would have to eat around 4 per cent less, or exercise around 20 per cent more,than another woman of a similar height and weight who doesn’t have the disorder, just tomaintain a steady weight, says Duncan. To find out if they could discover a potential treatment, Duncan and his colleagues turned to sheep. When Scottish greyface ewes are injected with male levels of testosterone, says Duncan, they show the symptoms of PCOS:they stop ovulating, develop polycystic ovaries and gain weight.
When Duncan’s team sprayed insulinup the noses of 12 of the sheep with PCOS-like symptoms, the sheep’s fat tissue appeared to burn more calories.

The group hasn’t yet studied the animals for long enough to see whether they lose weight.
“This was a short-term proof of-concept study,” says Duncan, who presented the findings at the Society for Endocrinology BES annual meeting in Brighton, UK, on12 November.
Duncanis currently applying for funding to trial the same approach in women with PCOS. Because insulin has been associated with satiety, Duncan hopes the women that try it will benefit from both effects. “May be squirting insulin up your nose gets you two benefits: it burns off calories and makes you not want to eat any more,”he says.

Hormone productionin sheep isn’t the same as that of humans, says Lina Schiffer at the University of Birmingham, UK,who chaired the session at which Duncan presented his results. “[Duncan’s] work has established the rationale and applicability of this in sheep with great success,” she says. “We now need to translate this into the humans etting.”

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