The aim of this study was to evaluate the effects of metformin in addition to diet and exercise on endocrine and metabolic disturbances in women with polycystic ovary syndrome (PCOS) in a prospective, double-blind, randomized, placebo (PBO) control trial. Thirty women with insulin resistance and PCOS received lifestyle modification and 1500 mg of metformin or placebo for 4 months. Before and after treatment, body mass index, waist/hip ratio, blood pressure, hirsutism, and menstrual patterns were evaluated. Serum concentrations of gonadotropins, androgens, progesterone, glucose, insulin, and lipids were measured. Lifestyle interventions resulted in similar weight and menstrual cycle's improvements in both groups. A significant reduction in serum fasting insulin, HOMA index, waist and testosterone levels was only observed with metformin. There were no significant changes in androstenedione, dehydroepiandrosterone sulfate, gonadotropins, and lipids levels. No other changes were observed in hirsutism or blood pressure. These findings suggest that metformin has an additive effect to diet and exercise to improve parameters of hyperandrogenism and insulin resistance. Although, a small decrease in body weight trough lifestyle changes could be enough to improve menstrual cycles in insulin-resistant women with PCOS.
All patients with thyroid carcinoma seen at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston between March 1944 and June 1968 were studied to determine the incidence of a second malignant tumor either before or after the diagnosis of thyroid cancer. Additionally, those patients having thyroid cancer as the initial cancer were studied to determine their risk of developing a second malignant tumor. Analysis of the latter was by the patient‐year method. Results showed that thyroid cancer patients have an increased number of second primary malignant tumors, and that they have a higher risk of developing a second primary after the diagnosis of thyroid cancer than the general population of the state of Connecticut. Possible explanations for these findings are discussed.
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