Influence of metformin therapy on peripheral blood androgenes concentrations in young women with metabolic syndrome
Justyna Kuliczkowska-Plaksej, Grazyna Bednarek-Tupikowska, Barbara Stachowska, Alicja Filus, Anna Trzmiel-Bira & Andrzej Milewicz
Introduction: Insulin resistance (IR) and visceral obesity, elements of metabolic syndrome (MS), contribute to hyperandogenaemia and may lead to hirsutism and other signs of hyperandrogenism. Little is known about the influence of metformin therapy (MET) on hormonal profile in women with MS and IR without menstrual irregularity.
Aim: To asses the influence of MET on sex steroids concentrations in young women with MS.
Methods: The study population consisted of 30 women aged 25-45 years, being evaluated before (IR1) and after (IR2) MET therapy (1700 mg/day for 4 months). Control group (K) consisted of 15 non-obese women. Anthropometric parameters as well as concentrations of glucose (fasting), insulin (fasting), total testosterone (TT), sex hormone binding globulin (SHBG) and dehydroepiandrosterone sulfate (DHEA-S) in peripheral blood were estimated. Homeostasis model assessment (HOMA), fasting insulin resistance index (FIRI), quantitative insulin-sensitivity check index (QUICKI) and free androgen index (FAI) were estimated. All parameters were evaluated before and after MET.
Results: DHEA-S concentrations did not differ among the groups and did not change after therapy. TT concentration was significantly higher in IR1 (P<0.005) and dicreased after MET (P<0.01). SHBG concentration was the lowest in IR1 (P<0.05) and did not change after therapy. FAI was the highest in IR1 (P<0.001), after MET significantly dicreased (P<0.01) and remained significantly higher than in K (P<0.05). Fasting glucose and insulin concentrations, HOMA and FIRI were the highest and QUICKI was the lowest in IR1 (P<0.05) and did not change after MET. Body mass, body mass index, waist and hip circumferences decreased after therapy (P<0.05).
Conclusion: i) Visceral obesity and IR are connected with diminished SHBG concentration and increased FAI values. ii) Metformin therapy has positive influence on decrease of free adrogenes levels. iii) Longer therapy and/or higher doses of metformin might possibly contribute to further limitation of hyperandrogenism.