The long-term effects of metformin in women with polycystic ovarian syndrome (PCOS) are inadequately studied.
Objective
The effects of metformin on women with PCOS during 24 months with respect to menses, hormones, and metabolic profiles are assessed.
Design
Prospective cohort.
Setting
A reproductive endocrinology clinic in a university-affiliated medical center.
Patients
One hundred nineteen women with PCOS, defined by the Rotterdam criteria, were enrolled.
Intervention
Metformin was given daily for 24 months.
Main Outcome Measures
The primary outcome was the proportion of patients with regular menstruation during treatment. Changes in anthropometric, hormonal, and metabolic parameters were also assessed. Analyses were performed using segmented regression analysis with a generalized estimating equation methodology. Outcomes are expressed as magnitude of change from the baseline.
Results
Both overweight (OW) and normal-weight (NW) women with PCOS had increased menstrual frequency and decreased body mass index (BMI), testosterone, and luteinizing hormone levels in the first 6 months. Further stratification showed that NW women exhibiting elevated testosterone at baseline had the largest magnitude of improvement at 6 months [odds ratio (OR), 7.21; 95% confidence interval (CI), 2.35 to 22.17], whereas OW patients with normal testosterone were most likely to achieve normal menses at 12 months (OR, 0.63; 95% CI, 0.47 to 0.77).
Conclusions
Metformin was associated with improvements in the menstrual cycle and most hormonal profiles in OW and NW women with PCOS during 24 months of treatment. Most parameters reached maximal response and steady-state after 6 months. Phenotypic differences in baseline BMI and testosterone level can be used as patient selection criteria or treatment prognostics.
PMID 29325133 29325133 DOI 10.1210/jc.2017-01739 10.1210/jc.2017-01739 Yang et al. 2018, Yang 2018
Cite this article
Yang, P., Hsu, C., Chen, M., Lai, M., Li, Z., Chen, C., Chen, S., & Ho, H. (2018). The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism, 103(3), 890-899. https://doi.org/10.1210/jc.2017-01739
Yang P, Hsu C, Chen M, Lai M, Li Z, Chen C, et al. The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2018;103(3):890-899. doi:10.1210/jc.2017-01739
Yang, Po-Kai, et al. "The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome." The Journal of clinical endocrinology and metabolism, vol. 103, no. 3, 2018, pp. 890-899.
Keywords
Adult, Anthropometry/methods, Body Mass Index, Drug Administration Schedule, Female, Humans, Hypoglycemic Agents/administration & Dosage/therapeutic Use, Longitudinal Studies, Luteinizing Hormone/blood, Menstruation/drug Effects, Metformin/administration & Dosage/therapeutic Use, Polycystic Ovary Syndrome/blood/drug Therapy/physiopathology, Prospective Studies, Testosterone/blood, Young Adult, Hypoglycemic Agents, Testosterone, Luteinizing Hormone, Metformin
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