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[Effect of long-term treatment with metformin on steroid levels and parameters of insulin resistance in women with polycystic ovary syndrome].
Cas Lek Cesk. 2001 Nov 08; 140(22):688-94.CL

Abstract

BACKGROUND

Insulin resistance is probably the key factor in the pathogenesis of polycystic ovary syndrome, and thus insulin sensitization can be a beneficial treatment. We tried to investigate effects of long-term therapy with metformin in polycystic ovary syndrome on steroid levels, ovarian steroidogenesis and on insulin resistance and secretion. We also tried to find predictors of the successful therapy (in terms of improvement of menstrual cyclicity).

METHODS AND RESULTS

24 oligo/amenorhoeic women with polycystic ovary syndrome were included into the study. Basal blood samples were taken for the determination of testosterone, estradiol, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate, 17OH progesterone, 17OH pregnenonole, sex-hormone binding globulin and cortisol. Gonadoliberin (GnRH) analogue test was performed with estimation of the same steroids and LH. Oral glucose tolerance test was done with dextrose, and with estimation of glucose, insulin, and C peptide. HOMA model assessment was used for calculation of insulin resistance and insulin secretion. All examinations were done before and after 27 +/- 4 weeks (average +/- standard deviation) of therapy with metformin 1000 mg/day. Significant improvement in menstrual cyclicity was observed in 58% of women. No significant change in basal steroid levels was found. A trend towards decline in insulin resistance and secretion was detected. Significant decrease in the mean stimulated testosterone level (from 1.74 to 1.54 nmol/l, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), 17OH progesterone level (from 3.32 to 2.37, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), LH (from 9.1 to 4.8 IU/l, 95% CI 6.4-12.8 and 3.4-6.8; p < 0.05), and estradiol level (from 0.91 to 0.43 nmol/l, 95% CI 0.69-1.19 and 0.38-0.65; p < 0.01) were detected. The best prediction of the improvement in menstrual cyclicity after metformin was achieved with the combination of basal 17OH progesterone, androstendione, testosterone and SHBG. This model correctly classified 86.7% of subjects.

CONCLUSIONS

Long-term therapy with metformin led to the improvement in menstrual cyclicity, without significant change in basal steroid levels or parameters of insulin resistance.

Authors+Show Affiliations

Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha. jvrbikova@endo.czNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

cze

PubMed ID

11789058

Citation

Vrbíková, J, et al. "[Effect of Long-term Treatment With Metformin On Steroid Levels and Parameters of Insulin Resistance in Women With Polycystic Ovary Syndrome]." Casopis Lekaru Ceskych, vol. 140, no. 22, 2001, pp. 688-94.
Vrbíková J, Hill M, Stárka L, et al. [Effect of long-term treatment with metformin on steroid levels and parameters of insulin resistance in women with polycystic ovary syndrome]. Cas Lek Cesk. 2001;140(22):688-94.
Vrbíková, J., Hill, M., Stárka, L., Cibula, D., Snajderová, M., Sulcová, J., Vondra, K., & Bendlová, B. (2001). [Effect of long-term treatment with metformin on steroid levels and parameters of insulin resistance in women with polycystic ovary syndrome]. Casopis Lekaru Ceskych, 140(22), 688-94.
Vrbíková J, et al. [Effect of Long-term Treatment With Metformin On Steroid Levels and Parameters of Insulin Resistance in Women With Polycystic Ovary Syndrome]. Cas Lek Cesk. 2001 Nov 8;140(22):688-94. PubMed PMID: 11789058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effect of long-term treatment with metformin on steroid levels and parameters of insulin resistance in women with polycystic ovary syndrome]. AU - Vrbíková,J, AU - Hill,M, AU - Stárka,L, AU - Cibula,D, AU - Snajderová,M, AU - Sulcová,J, AU - Vondra,K, AU - Bendlová,B, PY - 2002/1/16/pubmed PY - 2002/2/1/medline PY - 2002/1/16/entrez SP - 688 EP - 94 JF - Casopis lekaru ceskych JO - Cas Lek Cesk VL - 140 IS - 22 N2 - BACKGROUND: Insulin resistance is probably the key factor in the pathogenesis of polycystic ovary syndrome, and thus insulin sensitization can be a beneficial treatment. We tried to investigate effects of long-term therapy with metformin in polycystic ovary syndrome on steroid levels, ovarian steroidogenesis and on insulin resistance and secretion. We also tried to find predictors of the successful therapy (in terms of improvement of menstrual cyclicity). METHODS AND RESULTS: 24 oligo/amenorhoeic women with polycystic ovary syndrome were included into the study. Basal blood samples were taken for the determination of testosterone, estradiol, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate, 17OH progesterone, 17OH pregnenonole, sex-hormone binding globulin and cortisol. Gonadoliberin (GnRH) analogue test was performed with estimation of the same steroids and LH. Oral glucose tolerance test was done with dextrose, and with estimation of glucose, insulin, and C peptide. HOMA model assessment was used for calculation of insulin resistance and insulin secretion. All examinations were done before and after 27 +/- 4 weeks (average +/- standard deviation) of therapy with metformin 1000 mg/day. Significant improvement in menstrual cyclicity was observed in 58% of women. No significant change in basal steroid levels was found. A trend towards decline in insulin resistance and secretion was detected. Significant decrease in the mean stimulated testosterone level (from 1.74 to 1.54 nmol/l, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), 17OH progesterone level (from 3.32 to 2.37, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), LH (from 9.1 to 4.8 IU/l, 95% CI 6.4-12.8 and 3.4-6.8; p < 0.05), and estradiol level (from 0.91 to 0.43 nmol/l, 95% CI 0.69-1.19 and 0.38-0.65; p < 0.01) were detected. The best prediction of the improvement in menstrual cyclicity after metformin was achieved with the combination of basal 17OH progesterone, androstendione, testosterone and SHBG. This model correctly classified 86.7% of subjects. CONCLUSIONS: Long-term therapy with metformin led to the improvement in menstrual cyclicity, without significant change in basal steroid levels or parameters of insulin resistance. SN - 0008-7335 UR - https://www.unboundmedicine.com/medline/citation/11789058/[Effect_of_long_term_treatment_with_metformin_on_steroid_levels_and_parameters_of_insulin_resistance_in_women_with_polycystic_ovary_syndrome]_ L2 - https://medlineplus.gov/polycysticovarysyndrome.html DB - PRIME DP - Unbound Medicine ER -