Metformin decreases bone turnover markers in polycystic ovary syndrome: a post hoc study

Abstract

Objective: To study the effects of metformin treatment on bone turnover in women with polycystic ovary syndrome (PCOS), as measured by serum concentrations of bone turnover markers. Design: Post hoc study of a previously conducted prospective multicenter, placebo-controlled, randomized study. Setting: University clinic. Patient(s): The study cohort consisted of 74 non-obese women (body mass index < 27 kg/m 2) and 44 obese women (body mass index R 27 kg/m 2) diagnosed with PCOS, with a mean age of 27.6 AE 4.0 (SD) years. Intervention(s): Randomization to receive metformin or placebo for 3 months. Main Outcome Measure(s): Serum levels of bone formation marker procollagen type I amino-terminal propeptide (PINP) and bone resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX) at baseline and after metformin/placebo treatment. Result(s): Serum levels of PINP and CTX were similar between the metformin and placebo groups at baseline in the whole study population. Obese women, when compared with non-obese, had lower baseline levels of PINP and CTX. Levels of PINP and CTX were significantly reduced in the whole study population, as well as in both non-obese and obese women after 3 months of metformin treatment, whereas no significant changes were observed in the placebo group. Conclusion(s): Metformin treatment, when compared with placebo, was associated with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS. Clinical Trial Registration Number: NCT00994812.

The effects of metformin and alendronate in attenuating bone loss and improving glucose metabolism in diabetes mellitus mice

“…Consistent with the literature, this research found that participants who reported that metformin use is involved in a lower risk of osteoporosis in adult women independent of type 2 diabetes mellitus and obesity [ 11 , 41 ]. This also accords with our earlier observations, which showed that the metformin decreased bone turnover marker and influence bone formation in clinical studies [ 42 , 43 ]. However, we have also noticed that the effect of metformin on bone metabolism is significantly weaker than the use of alendronate, so the use of metformin alone in the treatment of diabetic osteoporosis may require further verification.…”

Clinical and radiographic variables related to implants with simultaneous grafts among type 2 diabetic patients treated with different hypoglycemic medications: a retrospective study

“…However, there are some studies reporting the side effect of metformin on bone. A post hoc study reported that metformin decreased the level of bone turnover factors and hindered the bone remodeling in polycystic ovary syndrome [50]. This effect may compromise the self-repair of minor bone tissue damage.…”

Lean Women on Metformin and Oral Contraceptives for Polycystic Ovary Syndrome Demonstrate a Dehydrated Osteosarcopenic Phenotype: A Pilot Study

“…The bone mass and bone mineral content were decreased in the PCOS group, and bone mineral density has been found to be lower in lean patients than in matched controls [70]. In the cohort study of Lingaiah et al, metformin treatment, when compared with a placebo, was related with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS [71].…”