Evaluation of metformin treatment in patient with polycystic ovary syndrome in Kirkuk city
DOI:
https://doi.org/10.15218/zjms.2012.0009Keywords:
polycystic ovary syndrome, insulin resistanceAbstract
Background and objectives: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of fertile age, affecting 5-10% of the female population. The aim of the present study is to evaluate the endocrine and metabolic effects of metformin in patients with polycystic ovary syndrome in Kirkuk city.
Methods: Eighty female with polycystic ovary syndrome (PCOS), were classified in to two groups, the first group ,who received Clomifene citrate and Metformin hydrochloride included 45 patients and the second group , who received Clomifene citrate only (control group) included 35 patients. All study patients, were diagnosed as polycystic ovary syndrome and they were on treatment at least two months before blood sample collection. Laboratory assessment that obtained included serum, free testosterone, leptin and insulin glucose and lipid profile.
Results: No significant differences in median of, serum insulin, insulin resistance or serum leptin between study groups were observed. The median free serum testosterone was significantly lower (23 pg/ml) in those treated with metformin compared to those on ordinary treatment (50 pg/ml). Fasting serum glucose, HDL – cholesterol and total cholesterol were significantly higher in group without metformin (116.2 , 41.3 , 161.8 mg/dL respectively) compaired to group with metformin (101.5, 34.3 , 138.8 mg/dL respectively). The remaining biomarkers (serum LDL-cholesterol, serum VLDL-cholesterol and triglyceride) showed no statistically significant differences between two groups.
We conclude that metformin treatment has beneficial effects on serum, free testosterone cholesterol and glucose in obese women with PCOS.
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References
Ehrmann DA. Polycystic ovary syndrome .N Engl J. Med 2005; 352:12-16.
Balen AH, Conway GS, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum. Reprod 1995 ;10: 2107-2111.
Franks S , Gilling-Smith C, Waston H, Willis .Insulin action in the normal and polycystic ovary. Endocrinol Metab Clin. North Am 1999; 28: 361-7.
Nelson VL, Qin KN, Rosenfield RL. The biochemical basis for increased testosterone production in theca cells propagated from patients with PCOS. J Clin Endocrinol Metab 2001;86:5925-31.
Nestler JE, Jakubowicz DJ, De vargas AF, Brick C, Quintero N, Medina F. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 1998; 83:2001-6.
Moghetti P. Castello R, Negri C. Insulin infusion amplifies 17 alfa-hydroxy corticosteriod intermediates response to adrenocorticotropin in hyperandrogenic women; apparent relative impairment of 17,20-lyase activity. J Clin Endocrinol Metab 1996; 81:881-6
Nestler JE, Powers LP, Matt DW .A direct effect of hyperinsulinemia on serum sex hormone- binding globulin levels in obese women with poly cystic ovary syndrome. JClin Endocrinol Metab 1991; 72:83-8.
Brzechffa PR, Jakimiuk AJ, Agarwal SK . Serum immunoreactive lepti concentrations in women with polycystic ovarian disease. J Clin Endocrinol Metab 1996 ; 81:4166-4169.
Hanson RL, Pratley RE, ogardus C. Evaluation of simple indices of insulin secretion for use in epidemiologic studies. Am J Epidemiol 2000; 151:190-198.
Martin A and Crook.Normal female gonadal function in: Clinical chemistry and metabolic medicine, 7thed hodder Arnold. 338Eeuston road, London. 2006; P 148-149.
Chapman IM, Wittert GA, Norman A. Circulating leptin concentration in polycystic ovary syndrome: relation to anthropometric and metabolic parameter. Clin Endocrinol 1997 ;46:175-9.
Laughlin GA, Morales AJ, Yers SS. serum leptin levels in women with polycystic ovary syndrome: the role of insulin resistance / hyperinsulineamia. J Clin Endocrinol Metab 1997 ;82:1692-1700.
Micic D, Macut D, Dieguez C. leptin levels and insulin sensitivity in obese and non-obese patients with PCOS. Gynecol Endocrinol 1997; 11: 315-320.
Soliman MY.metformin and polycystic ovary syndrome. International J Health sciences 2007; 1(1):89-94.
Brzechffa PR, Jakimiuk AJ, Agarwal SK. Serum immunoreactive leptin concentrations in women with polycystic ovarian disease. J Clin Endocrinol Metab 1996 ; 81:4166-4169.
Ardekani JM, Tarof N, Aflatonian A. Relationship between free leptin and insulin resistance in women with PCOS. Iranian J Reprod Med 2009 ; 7(2):53-8.
Carmina E, Koyama T, Chang L, Stanczyk FZ, Lobo RA .does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome?. AMJ obstet Gynocol 1992 ; 167: 1807-12
George RA, William ER, Bruce RC. Metformin directly inhibits androgen production in human thecal cells. Fertil Steril 2001 ; 76:517-24.
Victorin ES, Holm J, Labrie, Nilsson L, Janson PO, Ohlsson C . Are there any sensitive and specific sex steroid markers for polycystic ovary syndrome?. Clin Endocrinol Metab 2010 ; 95(2): 810-819.
Lobo RA and Carmina E. The importance of diagnosing the polycystic ovary syndrome. Ann Intern Med 2000; 132: 989-993.
Legro RS, Kunselman AR, Doelson WC, Dunaif A .Prevalence and predictor of risk for type 2 diabetes mellitus and impaired glucose tolerance in poly cystic ovary syndrome: a prospective controlled study in 254 affected women. J Clin Endocrinol Metab 1999; 84:165-9
Kimberly E, Ivanna VT, Margaret S.Use of metformin for ovulation induction in women who have polycystic ovary syndrome with or without evidence of insulin resistance. J Clin Endocrinol Metab 2006; 28(7): 595-599.
Lyndal R, Harborne NS, Jane E. Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses. Clin Endocrinol metab 2005; 90: 4593-8
Nestler JE. Metformin for the treatment of poly cystic ovary syndrome. N Engl J Med 2008; 358: 47-54.
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Copyright (c) 2012 Thulfiqar Abdulla Mohammed Al-jaf, Sanaa AL-Mandalawi, Iman Sabah, Emil Nasir Azzo, Ibaa Gassan, Nazhet Abdul qadir (Author)
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