Abstract:ObjectiveTo inbestigate the clinical effect of Metformin in the treatment of polycystic ovary syndrome(PCOS).MethodsFrom January 2012 to August 2013,58 PCOS patients treated in our hospital were selecteded into PCOS group and 85 healthy women were into control group.The PCOS patients were treated with 850 mg Metformin,twice daily for 24 weeks,53 patients completed the treatment finally.The levels of serum insulin and LH,FSH,T,E2,PRL,PROG,DHEA-S,SHBG were compared between the PCOS group and control group.The changes of indexes mentioned above before and after therapy were compared in PCOS group.The improvement of the menstrual cycle during the treatment and the pregnancy rate after medication by follow-up visits were monitored.ResultsIn the PCOS group,the body weight,BMI,FIns,2 h Ins,HOMA-IR,LH,LH/FSH,and T were higher than those in the control group,and the SHBG level was lower than that in the control group,and the differences were statistically significant(P<0.05).The other indicators of the two groups were compared,and the differences were not statistically significant(P>0.05).The indexes including BMI,LH,LH/FSH,T,FIns,2 h Ins and HOMA-IR were lower than those before treatment,and SHBG was higher than before treatment,the differences were statistically significant(P<0.05).The FSH,DHEA-S,E2,PRL and PROG before and after treatment were compared,and the differences were not statistically significant(P>0.05).In PCOS group,11 patients(20.75%)had regular menstrual cycle before treatment,after 3 months of therapy,the proportion of menstrual regularity was 69.81%,and the proportion of menstrual regularity was 75.47%after the 6 months of treatment,which were all higher than before treatment,the differences were statistically significant(P<0.05).Besides,the pregnancy rate was 46.67%in the sixth months after treatment.ConclusionThe levels of sex hormones,menstrual and reproductive status in PCOS patients were significantly varied from those of normal women.Metformin could effectively improve the sex hormone level,adjust the menstrual cycle disorder,and improve the pregnancy rate.It is a good choice for the treatment of PCOS.
Pasquali R.Metformin in women with PCOS,pros[J].Endocrine,2015,48(2):422-426.
[18]
Johnson NP.Metformin use in women with polycystic ovary syndrome[J].Ann Transl Med,2014,2(6):56.
[1]
Genazzani AD,Ricchieri F,Lanzoni C.Use of metformin in the treatment of polycystic ovary syndrome[J].Womens Health(Lond),2010,6(4):577-593.
[2]
Haas J,Bentov Y.Should metformin be included in fertility treatment of PCOS patients?[J].Med Hypotheses,2017,100(2017):54-58.
[3]
Sir-Petermann T,Ladron GA,Villarroel AC,et al.Polycystic ovary syndrome and pregnancy[J].Rev Med Chil,2012,140(7):919-925.
[4]
Mather KJ,Verma S,Anderson TJ.Improved endothelial function with metformin in type 2 diabetes mellitus[J].J Am Coll Cardiol,2001,37(5):1344-1350.
[5]
Palomba S,Falbo A,Zullo F,et al.Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review[J].Endoc Rev,2009,30(1):1-50.
[6]
Burghen GA,Givens JR,Kitabchi AE.Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease[J].J Clin Endoc Met,1980,50(1):113-116.
[7]
Goodman NF,Cobin RH,Futterweit W,et al.American association of clinical endocrinologists,american college of endocrinology,and androgen excess and pcos society disease state clinical review:guide to the best practices in the evaluation and treatment of polycystic ovary syndrome-part 2[J].Endoc Pract,2015,21(12):1415-1426.
[8]
Moghetti P,Castello R,Negri C,et al.Metformin effects on clinical features,endocrine and metabolic profiles,and insulin sensitivity in polycystic ovary syndrome:a randomized,double-blind,placebo-controlled 6-month trial,followed by open,long-term clinical evaluation[J].J Clin Endoc Met,2000,85(1):139-146.
[9]
Shetelig LT,Stridsklev S,Carlsen SM,et al.Cervical length and androgens in pregnant women with polycystic ovary syndrome:hasmetforminanyeffect?[J].JClinEndocMet,2016,101(6):2325-2331.
[10]
Nehir Aytan A,Bastu E,Demiral I,et al.Relationship between hyperandrogenism,obesity,inflammation and polycystic ovary syndrome[J].Gynecol Endocrinol,2016,32(9):709-713.
[11]
Nestler JE,Powers LP,Matt DW,et al.A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome[J].J Clin Endoc Met,1991,72(1):83-89.
[12]
Diamanti-Kandarakis E,Alexandraki K,Protogerou A,et al.Metformin administration improves endothelial function in women with polycystic ovary syndrome[J].Eur J Endoc,2005,152(5):749-756.
[13]
Ortega-Gonzalez C,Luna S,Hernandez L,et al.Responses of serum androgen and insulin resistance to metformin and pioglitazoneinobese,insulin-resistantwomenwithpolycystic ovary syndrome[J].J Clin Endoc Met,2005,90(3):1360-1365.
[15]
Victor VM,Rovira-Llopis S,Banuls C,et al.Metformin modulates human leukocyte/endothelial cell interactions and proinflammatory cytokines in polycystic ovary syndrome patients[J].Atherosclerosis,2015,242(1):167-173.
[16]
Naderpoor N,Shorakae S,Courten B,et al.Metformin and lifestyle modification in polycystic ovary syndrome:systematic review and meta-analysis[J].Hum Reprod Update,2015,21(5):560-574.
[17]
Morin-Papunen LC,Koivunen RM,Ruokonen A,et al.Metformin therapy improves the menstrual pattern with minimal endocrine and metabolic effects in women with polycystic ovary syndrome[J].Fertil Steril,1998,69(4):691-696.
[19]
Mesbah F,Moslem M,Vojdani Z,et al.Does metformin improve in vitro maturation and ultrastructure of oocytes retrieved from estradiol valerate polycystic ovary syndromeinduced rats[J].J Ovarian Res,2015,8(1):74.
[20]
Kurzthaler D,Hadziomerovic-Pekic D,Wildt L,et al.Metformin induces a prompt decrease in LH-stimulated testosterone response in women with PCOS independent of its insulin-sensitizing effects[J].Reprod Biol Endocrinol,2014,12(1):1-8.