ORIGINAL ARTICLES   

Minerva Ginecologica 2001 August;53(4):239-50

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Effects of metformin on the insulin resistance and on ovarian steroidogenesis in women with polycystic ovary syndrome

De Conciliis B., Passannanti G., Romano L., Santarpia R.

Background. Polycystic ovary syndrome is considered the most frequent endocrine abnormality during the fertile age. Hyperinsuli-nemia, typical of this syndrome, alters the functionality of the cytochrome P450 c 17 alfa and this causes an exaggerated secretion of male hormones produced by the female gonad. Objective of this study was to verify if the reduction of the circulating insulin levels, obtained through therapy with metformin, caused the reduction of LH levels, LH:FSH ratio, of testosterone and androstenedione levels, but also of cholesterolemia, triglyceridemia, BMI, and naturally of insulinemia, glycemia, as well as an increase in HDLC (high density lipoprotein cholesterol).
Methods. The presence of insulin-resistance and hyperinsulinemia, in 15 women aged between 20 and 30 with BMI >26 kg/m2, has been verified with test loaded with glucose; 500 mg of metformin have been given to these women three times a day before meals for 12 weeks. LH and FSH levels, LH:FSH ratio testosterone, androstenedione, progesterone, estradiol levels, cholesterolemia, trygliceridemia, HDLC and BMI have been considered in each patient before and after therapy.
Results. A statistically significant modification of all measured parameters was observed but the most important data is the reduction of the androgens.
Conclusions. The reduction of insulinemia seems to be actually associated with a reduction of circulating androgens in women with polycystic ovary syndrome. As well as the reproductive function, this insulin-sensitizing agent has the further «theoretical» advantage of a possible favourable effect also on the complications of the polycystic ovary syndrome specifically connected with: glucose-intolerance, dislipidemia, arteriosclerosis and hypertension. To consider the effects on the complications of the syndrome it would be necessary to give the drug for a period longer than 12 weeks.