The effects of metformin therapy in women with idiopathic hirsutism
Kursad Unluhizarci, Nuran Ahu Baysal, Zuleyha Karaca, Fatih Tanriverdi & Fahrettin Kelestimur
Hirsutism, which is characterized by excessive growth of terminal hair in a male pattern, is a common clinical condition in women. Among its etiologies, idiopathic hirsutism (IH) is considered to be one of the most common forms of hirsutism. We have previously shown the presence of insulin resistance in women with IH and our aim was to investigate the effects of metformin therapy in women with IH. The study was approved by the local Ethics Committee. Sixteen women with IH (mean age 21.6±1.1 years, BMI: 24.9±0.8 kg/m2) and 13 healthy women (mean age 27.1±0.5 years, BMI: 22.4±0.9 kg/m2) were included in the study. The presence of insulin resistance was investigated by using basal insulin levels, insulin responses to oral glucose tolerance test (OGTT) and HOMA score in both groups. Patients with IH had significantly (P<0.05) higher basal insulin levels (20.6±4.9 vs 8.1±1.2 mU/l), area under the curve (AUC) of insulin during OGTT (10659.0±2496.4 vs 3509.6±708.3 mU/dlx 2 h), insulin levels at 2 h of OGTT (125.9±36.2 vs 13.9±2.1 mU/l) and HOMA-IR (3.6±0.7 vs 1.5±0.2) in comparison to control subjects. Patients were treated with metformin (1700 mg/day) for 6 months and insulin resistance parameters were re-evaluated. Although it did not reach a significant level, basal insulin level decreased to 13.8±1.6 mU/l, AUC of insulin during OGTT decreased to 7725.8±1992.1 mU/dlx 2 h, insulin levels at 2 h of OGTT decreased to 52.0±12.3 mU/l and HOMA-IR decreased to 2.5±0.3. Our results confirmed the presence of insulin resistance in women with IH. Although limited, 6 months of metformin therapy had beneficial effects on insulin resistance in women with IH. Long term effects of metformin therapy in women with IH should be investigated.