Metformin administration is more effective when non-obese patients with polycystic ovary syndrome show both hyperandrogenism and hyperinsulinemia
- 1 January 2007
- journal article
- clinical trial
- Published by Taylor & Francis Ltd in Gynecological Endocrinology
- Vol. 23 (3), 146-152
- https://doi.org/10.1080/09513590701214398
Abstract
Background. Polycystic ovary syndrome (PCOS) is a common endocrine disease that is frequently observed to be related to increased insulin resistance independent of body weight. The use of insulin-sensitizer compounds, such as metformin, permits great improvement of such metabolic abnormality, restoring ovarian function and gonadal steroid synthesis and reducing insulin resistance. Aim. On this basis we aimed to evaluate a group of non-obese amenorrheic PCOS patients before and after 6 months of metformin administration (500 mg orally twice daily) to better understand upon which basis of clinical and endocrine parameters metformin administration might be chosen as a putative therapeutic tool. Method. A group of non-obese PCOS patients (n = 42) was enrolled after informed consent. They underwent an oral glucose tolerance test for insulin, glucose and C-peptide levels and provided blood samples for determination of plasma levels of luteinizing hormone (LH), follicle-stimulating hormone, prolactin, estradiol, androstenedione, 17-hydroxyprogesterone, insulin, cortisol and testosterone levels on two occasions: before and on day 7 of the first menstrual cycle occurring after the 5th month of treatment. Results. Plasma LH, estradiol, insulin and C-peptide were decreased significantly by metformin treatment in the entire group of PCOS patients. When subdividing PCOS patients according to insulin sensitivity (i.e. hyper- and normoinsulinemic subjects), a greater rate of positive endocrine changes was observed in hyperinsulinemic patients and the highest rate was observed in hyperinsulinemic hyperandrogenic subjects. Menstrual cyclicity was recovered in all patients under treatment. Conclusions. Our data show that metformin modulates ovarian function and greatly affects LH secretion through reduction of the hyperandrogenic condition. The highest rate of endocrine changes was observed in the hyperinsulinemic hyperandrogenic non-obese PCOS patients. Our study demonstrates that metformin administration is more appropriate in hyperinsulinemic hyperandrogenic non-obese PCOS patients.Keywords
This publication has 27 references indexed in Scilit:
- Nonobese women with polycystic ovary syndrome respond better than obese women to treatment with metforminFertility and Sterility, 2004
- Metformin administration modulates and restores luteinizing hormone spontaneous episodic secretion and ovarian function in nonobese patients with polycystic ovary syndromeFertility and Sterility, 2004
- POLYCYSTIC OVARY SYNDROMEEndocrinology and Metabolism Clinics of North America, 1998
- Effects of Metformin on Spontaneous and Clomiphene-Induced Ovulation in the Polycystic Ovary SyndromeThe New England Journal of Medicine, 1998
- Metformin therapy improves the menstrual pattern with minimal endocrine and metabolic effects in women with polycystic ovary syndromeFertility and Sterility, 1998
- Decreases in Ovarian Cytochrome P450c17α Activity and Serum Free Testosterone after Reduction of Insulin Secretion in Polycystic Ovary SyndromeThe New England Journal of Medicine, 1996
- Efficacy of Metformin in Patients with Non-Insulin-Dependent Diabetes MellitusThe New England Journal of Medicine, 1995
- MetforminDrugs, 1995
- Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancyMetabolism, 1994
- Insulin Resistance and Insulin Secretory Dysfunction as Precursors of Non-Insulin-Dependent Diabetes Mellitus: Prospective Studies of Pima IndiansThe New England Journal of Medicine, 1993