Background: Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance, two major contributors to cardiovascular risk. Even in the absence of detectable insulin resistance, lean, non-diabetic PCOS women demonstrate increased circulating levels of advanced glycated end products (AGEs), known proatherogenic molecules. This adverse cardiovascular risk profile should be considered in the syndromes management.
Objective: To investigate whether oral contraceptives (OCPs) or metformin, the commonest pharmaceutical treatments of PCOS, affect serum AGEs levels in PCOS women.
Patients-methods: Of 48 lean, nondiabetic PCOS women were randomized to the following treatments for 3 months:
Group A: 16 patients (mean age: 22.5 years, mean BMI: 21.76 kg/m2) received an OCP containing 30 μg ethinylestradiol plus 3 mg drospirenone.
Group B: 16 patients (mean age: 21.19 years, mean BMI: 21.09 kg/m2) received an OCP containing 35 μg ethinylestradiol plus 2 mg cyproterone acetate (CA).
Group C: 16 patients (mean age: 20.75 years, mean BMI: 21.68 kg/m2) received metformin (1700 mg/day).
Serum AGEs levels were determined before and after 3 months of treatment.
Results: The three groups had similar age, BMI and AGEs levels at baseline. The BMIs remained unaltered in all treatment groups. Post treatment mean serum AGEs levels were not significantly altered in Groups A (pre vs post: 9.383±0.22 vs 8.900±0.5, P=0.66) and B (pre vs post: 9.980±0.15 vs 10.270±0.20, P=0.22), while they significantly decreased in Group C (pre vs post: 9.310±0.33 vs 8.840±0.32, P=0.02).
Conclusions: For the first time, OCPs are shown to lack significant effects on circulating AGEs in PCOS women, at variance with metformin which is confirmed to reduce AGEs levels, in accord with previously published data. Thus, metformin may be superior to OCPs in alleviating the cardiovascular risk associated with PCOS.
25 - 29 Apr 2009
European Society of Endocrinology