Galindo GCG, Hernández MI, Ayala AR

Language: Spanish
References: 12
Page: 181-186
PDF size: 154.07 Kb.

ABSTRACT

Objective: To verify the medical effects of metformin in polycystic ovary syndrome patients.
Method: 10 women with polycystic ovary syndrome were including in this prospective clinical study. After a baseline workup, body mass index (BMI) and waist hip index (WHI) were measured; the diagnosis of polycystic ovary syndrome was achieved with the following basal clinical studies: vaginal ultrasound, prolactin, thyroid profile, glucose, insulin, testosterone, androstenedione, 17-hidroxiprogesterone, dehydroepiandrosterone sulfate and cortisol. The diagnosis of insulin resistance was achieved by model homeostasis assessment and the relationship glucose/insulin. Patients were given 500 mg of metformin twice a day for 3 months and reevaluated.
Results: 8 of 10 patients who completed treatment, showed significant improvement in insulin resistance (only by homeostasis model); there were decrease in hirsutism (mean of 35.07%), without improve menstrual cyclicity, although we achieved at least one menstruation in 42.85% in cases with amenorrhea after 2 or 3 months of treatment. There were no changes in weight, BMI neither in ovarian volume and number of follicles.
Conclusion: A 3 month course of metformin therapy in women with polycystic ovary syndrome did not improve menstrual cyclicity, albeit significant decrease in insulin, insulin resistance and hirsutism was obtained.

REFERENCES

1. Utiger RD. Insulin and the polycystic ovary syndrome. N Engl J Med 1996;335(9):657-8.

2. Gibson M. Reproductive health and polycystic ovary syndrome. Am J Med 1995;98:67S-75S.

3. Marca V, Petraglia F. Insulin-lowering agents in the management of polycystic ovary syndrome. Endocr Rev 2003;24:633-67.

4. Carpenter S, Rock J. Pediatric and adolescent gynecology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2000.

5. Tsilchorozidou T, Prelevic M. The role of metformin in the management of polycystic ovary syndrome. Curr Op Obstet Gynecol 2003;15:234-9.

6. Azzis R. Diagnostic criteria for polycystic ovary syndrome: a reappraisal. Fertil Steril 2005;83(5):1343-8.

7. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risk related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19(1):41-47.

8. Ferrannini E, Balkau B. Insulin: in search of a syndrome. Diabetic Med 2002;19:724-9.

9. Levy J, Mathews D, Hermans M. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 1998;21:2191-2.

10. Smirnakis K, Martínez A, Blatman K, Wolf M, et al. Early pregnancy insulin resistance and subsequent gestational diabetes mellitus. Diabetes Care 2004;27:1439-46.

11. Franks S. Polycystic ovary syndrome. N Engl J Med 1995;333(13):853-61.

12. Speroff L, Glass R, Kase N. Clinical gynecologic endocrinology and infertility. 6th ed. Philadelphia: Lippincott Williams & Wilkins, 1999.