The effects of metformin therapy on hirsutism, androgen and metabolic parameters in PCOS women
Background: PCOS is the most common endocrinopathy in women of reproductive age, characterized by hyperandrogenism and ovulatory dysfunction. The aim of this study was to evaluate the effects of metformin therapy on hirsutism, androgen and metabolic parameters in PCOS women.
Methods: Fifty PCOS women with hirsutism aged 2040 years were included in the study. PCOS diagnosis was made after excluding other causes of hirsutism and in accordance with Rotterdam criteria. Patients to be included in the study required not to receive any medication for PCOS, or for other conditions associated with insulin resistance, within the last 6 months. Fasting serum glucose, basal insulin, insulin during OGTT, HOMA-IR index, FSH, LH, PRL, TSH, total testosterone, DHEA-S, androstendione and lipid profile were determined. All patients were treated with metformin (1500 mg/day) for 12 months and all parameters were re-evaluated.
Results: Metformin treatment after 12 months significantly reduced: BMI (27.26±3.58 vs 22.75±1.37 kg/m2); P=0.009), waist circumference (87.32±6.93 vs 77.93±2.62 cm; P=0.007), hirsutism FG score (10.44 vs 8.8), BI (127.63±28.04 vs 70.15±11.39 pmol/l; P<0.05), HOMA-IR index (2.61±0.52 vs 1.55±0.78; P<0.01), total testosterone (2.93±0.67 vs 2.02±0.39 nmol/l; P=0.02), DHEA-S (450±80 vs 344.9±70.23 μg/dl; P<0.01), androstendione (3.67±0.88 vs 2.45±0.6 ng/ml; P<0.01), PRL (469.09±71.79 vs 317±85.79 μIU/ml; P<0.05), TSH (3.39±0.8 vs 2.32±0.46 mIU/l: P<0.01), total cholesterol (5.81±0.38 vs 5.31±0.3 mmol/l; P<0.05), tryglicerides (1.81±0.25 vs 1.26±0.24 mmol/l; P<0.05) LDL (4.08±0.32 vs 3.6±0.25 mmol/l; P<0.01) and not significantly changed fasting serum glucose levels, HDL cholesterol, FSH and LH. Significantly correlations were between: HOMA-IR index and hirsutism score (r=0.68), HOMA-IR index and basal insulin (r=0.96), testosterone and basal insulin (r=0.75), hirsutism score and waist circumference (r=0.75), hirsutism score and basal insulin (r=0.74), basal insulin and androstendione (r=0.74), basal insulin and DHEA-S (r=0.72).
Conclusion: The results of study shown that 12 months of metformin therapy had beneficial effects on hirsutism score, androgen levels and insulin resistance in PCOS women with hirsutism.