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The Effect of Metformin in Non-Obese Women with Polycystic Ovary Syndrome; Pilot Study  

Kim, Hyeong-Ok (Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University)
Kim, Kye-Hyun (Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University)
Publication Information
Clinical and Experimental Reproductive Medicine / v.35, no.3, 2008 , pp. 223-229 More about this Journal
Abstract
Objective: This pilot study was performed to investigate the effect of metformin on insulin resistance, hormone levels, and lipid profiles in non-obese patients with polycystic ovary syndrome. Methods: This study included 16 non-obese patients with polycystic ovary syndrome diagnosed at our hospital from June 2006 to September 2007. Blood samples were collected before and 6 months after metformin treatment for analysis of fasting serum glucose levels, fasting serum insulin levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and hormonal blood profile including FSH, LH, estradiol, testosterone, free testosterone, serum lipid profiles. Insulin resistance was estimated by calculating fasting glucose/insulin ratio (FGIR), 2 hr glucose/insulin ratio after 75 g glucose load. And we investigated insulin resistance and pancreatic beta cell function by calculating HOMA beta cell function and HOMA IR. Results: After the treatment of metformin, there was significant increase in 2 hr glucose/insulin ratio after 75 g glucose load (p=0.04) and decrease in HOMA IR (p=0.000). But serum lipid profiles did not change significantly. Also the metformin treatment induced a significant reduction in serum free testosterone and LH levels, and LH/FSH ratio (p=0.001, p=0.000, p=0.034). Conclusion: This pilot study showed that metformin might be effective in improving insulin sensitivity, ameliorating hyperandrogenemia in non-obese patients with polycystic ovary syndrome. Further investigations with larger number of patients and long-term observations are necessary to determine the role of metformin.
Keywords
Metformin; Polycystic ovary syndrome; Insulin resistance; Hyperandrogenemia;
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Times Cited By KSCI : 2  (Citation Analysis)
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1 Adam B, Kathy M. What is polycystic ovary syndrome? Hum Reported 2002; 17: 2219-27   DOI   ScienceOn
2 박영한, 황경주, 권혁찬, 양정인, 유희석, 김세광 등. 다낭성난소증후군 환자에서 체중과 임신이 내분비 양상 및 당 대사에 미치는 영향. 대한산부회지 1999; 42: 606-13
3 Ciampeli M, Lanzone A. Insulin and polycystic ovary syndrome: a new look at an old subject. Gynecol Endocrinol 1998; 12: 277-92   DOI
4 Baillargeon JP, Iuorno MJ, Nestler JE. Comparison of metformin and thiazolidiones in management of polycystic ovary syndrome. Curr Opin Endocrinol Diabetes 2002; 9: 303-11   DOI   ScienceOn
5 Diamanti-Kandarakis E, Kouli C, Tsianateli T, Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur J Endocrinol 1998; 138: 269-76   DOI
6 황규리, 최영민, 최두석, 백광현, 전혜원, 배광범 등. 다낭성난소증후군 환자에서 메트포민 치료의 효과와 인슐린 저항성. 대한산부회지 2004; 48: 1949-53
7 배광범. 과체중 및 비만 다낭성난소증후군 환자에서의 Metformin과 Rosiglitazone의 효용성. 대한불임학회지 2005; 32: 347-52
8 Velazquez E, Acosta A, Mendosa SG, Menstrual cyclicity after metformin therapy in polycystic ovary syndrome. Obstet Gynecol 1997; 90: 392-5   DOI   ScienceOn
9 Lord JM, Flight IH, Norman RJ. Insulin-sensitizing drugs (metformin, troglitazone, rosiglitazone, d-chiro-inositol) for polycystic ovary syndrome. Cochrane Database Syst Rev 2003; 3: CD003053
10 Velazquez EM, Mendoza S, Harmer T, Sosa F, Glueck CJ. Metformin therapy in polycystic ovary syndrome recedes hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while ascilitating normal menses and pregnancy. Metabolism 1994; 43: 647-54   DOI   ScienceOn
11 Nestler JE, Jakubowicz DJ, Evans WS, Pasquali R. Effects of metformin on spontaneous and clomiphene induced ovulation in the polycystic ovary syndrome. N Engl J Med 1998; 338: 1876-80   DOI   ScienceOn
12 Glueck C, Wang P, Fontine R, Tracy T, Smith L. Metformin to restore normal mens in oligo-amenorrhetic teenage girls with polycystic ovary syndrome. J adolesc health 2001; 29: 160-9   DOI   ScienceOn
13 문화숙, 주보선, 박세희, 송수진, 김철호, 문성은 등. 클로미펜-저항성 난소증후군으로 인한 불임 환자에서 메트포민의 치료 효과. 대한산부회지 2003; 46: 1920-5
14 Metthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and ${\beta}$-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985; 28: 412-9   DOI
15 Barbieri RL, Makris A, Randall RW, Daniels G, Kistner RW, Ryan KJ. Insulin stimulates androgen accumulation in incubation of ovarian stroma obtained from women with hyperandrogenism. J Clin Endocrinol Metab 1986; 62: 904-10   DOI
16 Velazquez EM, Mendoza SG, Wang P, Glueck CJ. Metformin therapy is associated with a decrease in plasma plasminogen activator inhibitor-1, lipoprotein (a), and immunoreactive insulin levels in patients with polycystic ovary syndrome. Metab 1997; 46: 454-61   DOI   ScienceOn
17 Tevik S, Huseyin V, Muge H, Menmet H. Oxidative stress on polycystic ovary syndrome and its contribution to the risk of cardiovascular disease. Clin Biochem 2001; 34: 407-13   DOI   ScienceOn
18 Choo V. WHO reassesses appropriate body-mass index for Asian populations. Lancet 2002; 360: 235   PUBMED
19 황경진, 장호선, 최호진, 조필제, 김미령, 이혁. 다낭성 난소증후군 환자에서 체외수정 시술 시 메트포민의 효과. 대한산부회지 2005; 48: 2181-9
20 Plymate SR, Matej LA, Jones RE, Friedl KE. Inhibition of sex hormone binding globulin production in human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab 1988; 67: 460-6   DOI
21 Fleming R, Hopkinson ZE, Wallace AM, Greer IA, Satter N. Ovarian function and metabolic factors in women with oligomenorrhea treated with metformin in a randomized double blind placebo-controlled trial. J Clin Endocrinol Metab 2002; 87: 569-77   DOI
22 Annos T, Taymor ML. Ovarian pathology associated with insulin resistance and acanthosis nigricans. Obstet Gynecol 1981; 58: 662-4   PUBMED
23 Richard S. Polycystic ovary syndrome: the new millennium. Mol Cell Endocrinol 2001; 184: 87-93   DOI   ScienceOn
24 Costello MF, Eden JA. A systematic review of the reproductive system effects of metformin in patients with polycystic ovary syndrome. Fertil Steril 2003; 79: 1-13   DOI   ScienceOn
25 Harborne L, Fleming R, Lyall H, Norman J, Sattar N. Descriptive review of the evidence for the use of metformin in polycystic ovary syndrome. Lancet 2003; 361: 1894-901   DOI   ScienceOn
26 The Rotterdam ESHRE/ASRM-Sponsored PCOS consensus on diagnostic criteria and long-term health risks related to polycystic ovarian syndrome (PCOS). Hum Reprod 2004; 19: 41-7   DOI   ScienceOn
27 김정연, 박기현, 정경아, 강경숙, 안철우, 배상욱 등. 다낭성난포증후군 환자에서 총 경동맥의 혈관내막 두께 측정을 통한 인슐린 저항성과 잠재성 동맥경화의 관계 분석. 대한산부회지 2001; 44: 1178-85
28 Nestler JE, Jakubowicz DJ. Decreases in ovarian cytochrome P450c17${\alpha}$ activity and serum free testosterone after reduction of insulin secretion in polycystic ovary syndrome. N Engl J Med 1996; 335: 617-23   DOI   ScienceOn
29 김성훈, 권혜은, 박은주, 채희동, 김정훈, 강병문 등. 과배란 유도 시 다낭성난소증후군 환자의 난포 액내 에스트라디올, 테스토스테론 및 인슐린 유사 성장인자-1의 분비 양상. 대한산부회지 2001; 44: 296-301
30 Diamanti-Kandarakis E, Spina G, Kouli C, Migdalis I. Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J Clin Endoclinol Metab 2001; 86: 4666-72   DOI