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Minerva Endocrinologica 2012 March;37(1):25-40

language: English

Neuroendocrine and endocrine dysfunction in the hyperinsulinemic PCOS patient: the role of metformin

Weickert M. O. 1, 2, Hodges P. 1, Tan B. K. 2, 3, Randeva H. S. 1, 2

1 Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK;
2 Division of Metabolic and Vascular Health Warwick Medical School, University of Warwick, Coventry, UK;
3 Department of Reproductive Medicine and Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK


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Metformin is a widely used and extensively studied insulin sensitising drug for the treatment of women with polycystic ovary syndrome (PCOS), with various actions in tissues responding to insulin that include the liver, skeletal muscle, adipose tissue, the endothelium of blood vessels, and the ovaries. Treatment of PCOS women with metformin has been shown to reduce fasting glucose levels, blood pressure, and serum androgens; further effects of metformin in women with PCOS may include direct effects on the central nervous system; and indirect effects via the modification of gut hormone and adipokine synthesis and/or secretion. A number of “novel” adipokines and metabolic factors have been recently identified which may play a role both in the pathogenesis and the treatment of women with PCOS. We here discuss recent advances in the area, with a focus on neuroendocrine and endocrine dysfunctions in women with PCOS and the potential role of metformin in this context.

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m.weickert@warwick.ac.uk