Medicinski Podmladak (Jan 2018)
The effect of metformin on clinical features of women with polycystic ovary syndrome
Abstract
Introduction: Insulin resistance (IR) is one of the main features of polycystic ovary syndrome (PCOS), and metformin is one of the most commonly prescribed insulin sensitizers in its treatment. Research carried out so far shows heterogeneous results on the effects of metformin on the hormonal and metabolic status of women with PCOS. The aim of the study was to investigate the effect of six-month treatment with metformin (2000 mg per day) on the hormonal and metabolic characteristics of women with PCOS, paired with healthy women by body mass index (BMI) and age. Material and Methods: A number of 20 women with PCOS [age: 23.5 ± 5.9 years, BMI: 24.8 ± 4.2kg / m2] and 20 healthy control group women were tested (age: 24.5 ± 5.3 years, BMI: 23.6 ± 3.0kg / m2). Polycystic ovary syndrome was diagnosed with ESHRE / ASRM criteria. Standard biochemical and hormonal parameters were determined, which were repeated in the PCOS group and after six months of metformin therapy. Insulin resistance was determined using a homeostatic model (HOMA-IR). Results: After six months of metformin therapy in the PCOS group, there was a significant increase in the frequency of menstrual cycle (65% versus 87%, p <0.001), reduction of the degree of hirzutism towards Ferrimann - Galway score (9.5 versus 8.5, p = 0.025), but after the therapy all parameters were still significantly different from the ZK group. After therapy, there was no difference in the concentration of triglycerides between PCOS and ZK (1.3 ± 0.7 versus 0.9 ± 0.4 mmol / L, p = 0.19), which were significantly higher in PCOS compared to ZK before therapy (1.4 ± 0.8 vs 0.9 ± 0.4 mmol / L, p = 0.03). There was no significant effect of BMI therapy, as well as on HOMA-IR and the concentration of androgens that were significantly higher in PCOS compared to ZK, while there was a favorable effect of metformin on the liver. Conclusion: Six-month treatment with metformin, at a dose of 2000 mg per day in women with PCOS, leads to a significant increase in the incidence of menstrual cycle, ovulation and reduction in the degree of hirsutism, as well as a beneficial effect on lipids and liver, and the independent effects of the drug on BMI and IR.
