Hyperinsulinaemia and insulin resistance play a key role in the development of the PCOS. Amenorrhoea, polycystic ovaries, hirsutism, high fasting insulin and high testosterone concentrations characterize polycistic ovary syndrome (PCOS). Hyperinsulinaemia is associated with serum C-reactive protein (CRP) levels. Elevated CRP in association with hyperinsulinemia is a significant risk factor for cardiovascular diseases.
We aimed to evaluate the effect of metformin on serum CRP levels in PCOS women. Thirty women with PCOS [BMI=27.8±1.9 kg/m2, aged 18-33 yr] were studied. Patients received metformin orally the dose of 850 mg/d. The patients were carefully interviewed, clinically examined, and laboratory tested to eliminate conditions probable to provoke an inflammatory response which was an exclusion criterion. At all patients we determined level of CRP, fasting insulin, blood glucosae, C-peptid, lipids, testosterone, FSH, LH, E2, T3, T4, TSH, PRL, cortisol, ACTH, GH. Serum CRP levels were measured with immunometric assay, level of insulin were measured with RIA before and after metformin treatment. Students T-test and percentile was reformed in statistical analysis.
Mean serum C-RP levels significantly decreased after metformin treatment (6.98±1.92 vs. 1.98±0.68 mg/l; P<0.05). Level of insulin reduced for 38% after metfromin treatment (242±71 v.s. 151±38 pmol/l). Mean total testosterone level decreased with metformin treatment (3.52±0.89, 1.66±0.47, P<0.05). Total cholesterol and low-density lipoprotein cholesterol levels decreased as well.
Level of CRP significantly correlated to the level of fasting insulin (r=0.57).
PCOS women have insulin resistance and high CRP level. In sum, metformin decreased level of CRP and insulin and decreased risk for cardiovascular disease. Metformin therapy improved hirsutism and menstrual cycles, as well.