Endocrine Abstracts (2017) 49 EP1134 | DOI: 10.1530/endoabs.49.EP1134

The efficiency of metformin in polycystic ovarian syndrome is not necessarily attributable to the improvement of insulin resistance

Zsuzsanna Szanto & Adelina Micheu

University of Medicine and Pharmacy, Targu Mures, Romania.

Insulin resistance has a pivotal role in the pathogenesis of polycystic ovarian syndrome (PCOS), thus insulin sensitizer therapy is beneficial. Purpose. Our purpose was to study the effectiveness of metformin in PCOS women, including those without insulin resistance. Matherials and methods. This study was conducted on 24 pacients (12 obese or overweight and 12 lean women), aged 21–31 years, diagnosed and treated with PCOS at the Clinical Department of Endocrinology Targu-Mure, during January 2013-March 2015. All patients received metformin therapy, including those without insulin resistance. Results Menstrual cycle disturbances (anovulation, bradi-oligomenorrhoea) before metformin therapy appeared in 91.6% of the obese or overweight women, and 83.3% of the lean women (21 cases from the 24). In 15 cases insulin level, glycaemia were measured, and HOMA-IR calculated. Mean insulin level was 13.06±14.53 mIU/l in the obese group, and 6.82±1.92 mIU/l in the lean group, and the corresponding mean HOMA-IR was 4.23±3.42 vs. 1.29±0.43. Among the 21 women (11 obese and 10 lean) with menstrual disturbance before metformin therapy these disturbances improved or pregnancy occurred in 11 cases (5 obese and 6 lean) during metformin treatment alone, which means a significant improvement (P=0.0085, RR=3.16, 95% CI=1.12–8.87). During metformin treatment alone, 14 women from the 24 presented normal menstrual cycle, normalized progesterone level or pregnancy occurrence (P=0.002, RR=3.83, 95% CI=1.33–11.03). Conclusion. Metformin therapy might resolve menstrual cycle disturbances not only in insulin resistant obese PCOS women, but also in those with normal weight and/or without insulin resistance.

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