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Metformin therapy increases insulin-like growth factor binding protein-1 in hyperinsulinemic women with polycystic ovary syndrome.
Eur J Obstet Gynecol Reprod Biol. 2004 Apr 15; 113(2):209-13.EJ

Abstract

OBJECTIVES

Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism, insulin resistance, compensatory hyperinsulinemia, and increased levels of free insulin-like growth factor-I (IGF-I), presumably due to a decline in IGF binding protein 1 (IGFBP-1). This study was designed to evaluate effects of metformin therapy on serum levels of IGFBP-1 and IGF-I.

STUDY DESIGN

Twenty-seven obese, hyperandrogenic PCOS women with elevated fasting insulin were treated for 12 weeks with metformin (500 mg p.o., t.i.d.). Serum levels of insulin, testosterone, sex hormone binding globulin (SHBG), IGF-I, and IGFBP-1 were measured before and after treatment. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed at baseline and at the end of therapy.

RESULTS

Metformin therapy significantly increased IGFBP-1 concentration by 38% (P = 0.05) but had no demonstrable effect on the total IGF-I levels. Fasting insulin levels declined by 38% (P = 0.0001) while the glucose/insulin ratio increased by 72% (P = 0.0001) and quantitative insulin sensitivity check index (QUICKI) increased by 8% (P = 0.0001). Metformin treatment also significantly decreased testosterone (by 37%, P = 0.0001) and increased SHBG concentration (by 16%, P = 0.04). Multiple linear regression analysis revealed that baseline IGFBP-1 levels correlated inversely and independently with two baseline parameters: WHR (P = 0.003) and free testosterone index (P = 0.04).

CONCLUSIONS

The present study shows that metformin therapy not only restores normal levels of insulin and testosterone, but also decreases the pool of free-bioactive IGF-I by increasing the levels of circulating IGFBP-1. We provide further arguments in favor of metformin therapy in hyperinsulinemic women with PCOS.

Authors+Show Affiliations

Department of Gynecology and Obstetrics, Karol Marcinkowski University of Medical Sciences, ul. Polna 33, 60-535 Poznan, Poland. pawelczyk@gpsk.am.poznan.plNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15063962

Citation

Pawelczyk, Leszek, et al. "Metformin Therapy Increases Insulin-like Growth Factor Binding Protein-1 in Hyperinsulinemic Women With Polycystic Ovary Syndrome." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 113, no. 2, 2004, pp. 209-13.
Pawelczyk L, Spaczynski RZ, Banaszewska B, et al. Metformin therapy increases insulin-like growth factor binding protein-1 in hyperinsulinemic women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2004;113(2):209-13.
Pawelczyk, L., Spaczynski, R. Z., Banaszewska, B., & Duleba, A. J. (2004). Metformin therapy increases insulin-like growth factor binding protein-1 in hyperinsulinemic women with polycystic ovary syndrome. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 113(2), 209-13.
Pawelczyk L, et al. Metformin Therapy Increases Insulin-like Growth Factor Binding Protein-1 in Hyperinsulinemic Women With Polycystic Ovary Syndrome. Eur J Obstet Gynecol Reprod Biol. 2004 Apr 15;113(2):209-13. PubMed PMID: 15063962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metformin therapy increases insulin-like growth factor binding protein-1 in hyperinsulinemic women with polycystic ovary syndrome. AU - Pawelczyk,Leszek, AU - Spaczynski,Robert Z, AU - Banaszewska,Beata, AU - Duleba,Antoni J, PY - 2003/03/03/received PY - 2003/07/25/revised PY - 2003/09/05/accepted PY - 2004/4/6/pubmed PY - 2004/8/12/medline PY - 2004/4/6/entrez SP - 209 EP - 13 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 113 IS - 2 N2 - OBJECTIVES: Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism, insulin resistance, compensatory hyperinsulinemia, and increased levels of free insulin-like growth factor-I (IGF-I), presumably due to a decline in IGF binding protein 1 (IGFBP-1). This study was designed to evaluate effects of metformin therapy on serum levels of IGFBP-1 and IGF-I. STUDY DESIGN: Twenty-seven obese, hyperandrogenic PCOS women with elevated fasting insulin were treated for 12 weeks with metformin (500 mg p.o., t.i.d.). Serum levels of insulin, testosterone, sex hormone binding globulin (SHBG), IGF-I, and IGFBP-1 were measured before and after treatment. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed at baseline and at the end of therapy. RESULTS: Metformin therapy significantly increased IGFBP-1 concentration by 38% (P = 0.05) but had no demonstrable effect on the total IGF-I levels. Fasting insulin levels declined by 38% (P = 0.0001) while the glucose/insulin ratio increased by 72% (P = 0.0001) and quantitative insulin sensitivity check index (QUICKI) increased by 8% (P = 0.0001). Metformin treatment also significantly decreased testosterone (by 37%, P = 0.0001) and increased SHBG concentration (by 16%, P = 0.04). Multiple linear regression analysis revealed that baseline IGFBP-1 levels correlated inversely and independently with two baseline parameters: WHR (P = 0.003) and free testosterone index (P = 0.04). CONCLUSIONS: The present study shows that metformin therapy not only restores normal levels of insulin and testosterone, but also decreases the pool of free-bioactive IGF-I by increasing the levels of circulating IGFBP-1. We provide further arguments in favor of metformin therapy in hyperinsulinemic women with PCOS. SN - 0301-2115 UR - https://www.unboundmedicine.com/medline/citation/15063962/Metformin_therapy_increases_insulin_like_growth_factor_binding_protein_1_in_hyperinsulinemic_women_with_polycystic_ovary_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301211503004597 DB - PRIME DP - Unbound Medicine ER -