The Effect of Ethinylestradiol (EE)/Cyproterone Acetate (CA) and EE/CA Plus Metformin Treatment on Adhesion Molecules in Cases with Polycystic Ovary Syndrome (PCOS)

Bilgir, Oktay; Kebapçılar, Levent; Taner, Cüneyt Eftal; Bilgir, Ferda; Kebapçılar, Ayşe Gül; Bozkaya, Giray; Yıldız, Yaşar; Yüksel, Arif; Sarı, İ̇smail

doi:10.2169/internalmedicine.48.2177

Cited by 29 publications

(28 citation statements)

References 31 publications

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“…An increasing body of evidence demonstrates that Met lowers androgen levels and improves endothelial injury in PCOS, independently of adiposity and insulin resistance [27]. In one study, both sVCAM-1 and sICAM-1 levels were decreased in PCOS by the combination of Met and ethinylestradiol/cyproterone acetate, in contrast to ethinylestradiol/cyproterone acetate mono-therapy [28]. In this research, an EE2/drospirenone combination was used and this might account for the results.…”

Section: Discussionmentioning

confidence: 84%

Soluble platelet/endothelial cell adhesion molecule (sPECAM)-1 is increased in polycystic ovary syndrome and related to endothelial dysfunction

Pepene¹

2012

Gynecological Endocrinology

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Striking evidence indicates endothelial impairment in polycystic ovary syndrome (PCOS) but the mechanisms linking PCOS status to cardiovascular risk remain elusive. Platelet/endothelial cell adhesion molecule (PECAM)-1 is a soluble (s) signaling molecule involved in inflammation and angiogenesis with predictive value for endothelial dysfunction in patients at risk. In a prospective, controlled study, sPECAM-1 levels and the relationships to metabolic, inflammatory and vascular PCOS traits were evaluated in 26 patients and 29-age- and body mass index-matched controls. To assess endothelial injury, carotid artery intimae-media thickness (CIMT) and brachial artery flow-mediated vasodilatation (FMD) were employed. Of the 26 women with PCOS, 25 completed a six-month metformin combined with ethinylestradiol 0.3 mg/drospirenone 3 mg therapy. Soluble PECAM-1 levels were increased in PCOS (p = 0.018 vs. Controls) and significantly decreased at follow-up (p = 0.0002). Smoking and weight had no effect on sPECAM-1 dynamics. In both univariate and multivariate analysis, basal sPECAM-1 was inversely related to FMD (r = -0.311, p = 0.021) but not CIMT. To conclude, sPECAM-1 is increased in PCOS, an effect reversed by combined metformin and anti-androgenic contraceptive therapy. Elevated sPECAM-1 contributes to endothelial dysfunction however further studies are inquired to assess its relevance as biomarker and potential therapeutic target in PCOS.

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Section: Discussionmentioning

confidence: 84%

Soluble platelet/endothelial cell adhesion molecule (sPECAM)-1 is increased in polycystic ovary syndrome and related to endothelial dysfunction

Pepene¹

2012

Gynecological Endocrinology

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“…In the present work, we have observed that the increased levels of ICAM-1 and E-selectin adhesion molecules characteristic of PCOS subjects are lower after treatment with metformin, in accordance with a reduction in leukocyteeendothelium interactions. Available data regarding the effect of metformin on adhesion molecules are contradictory; for example, Bilgir et al showed that treatment with ethinylestradiol (EE)/cyproterone acetate (CA) plus metformin decreases levels of VCAM-1 and ICAM-1 in PCOS [41], while Kandarakis et al reported that metformin treatment decreases levels of VCAM-1 only. These discrepancies may be due to variations in the dose and/or duration of metformin treatment in question [42].…”

Section: Discussionmentioning

confidence: 99%

Metformin modulates human leukocyte/endothelial cell interactions and proinflammatory cytokines in polycystic ovary syndrome patients

et al. 2015

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“…A total of 40 women with PCOS, evaluated based on the Rotterdam criteria, were enrolled in the randomized clinical trial conducted by Bilgir et al 21 in Turkey. The patients received either metformin (1,700 mg/d) with an OCP (ethinylestradiol 35 µg plus cyproterone acetate 2 mg) or the OCP alone for 3 months.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome

Yang¹,

Choi²

2015

TCRM

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BackgroundPolycystic ovary syndrome (PCOS) is an endocrinopathy that affects approximately 10% of reproductive-aged women throughout their lives. Women with PCOS present with heterogeneous symptoms including ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. Therefore, lifelong individualized management should be considered. Pharmacological agents commonly used to manage the symptoms are metformin and oral contraceptive pills. Although these medications have been beneficial in treating PCOS symptoms, their efficacy and safety are still not entirely elucidated. This study aimed to report the efficacy and safety of metformin, oral contraceptives, or their combination in the treatment of PCOS and to define their specific individual roles.MethodsA literature search of original studies published in PubMed and Scopus was conducted to identify studies comparing metformin with oral contraceptives or evaluating the combination of both in PCOS.ResultsEight clinical trials involving 313 patients were examined in the review. The intervention dosage of metformin ranged from 1,000 to 2,000 mg/d and that of oral contraceptives was ethinylestradiol 35 µg and cyproterone acetate 2 mg. Lower body mass index was observed with regimens including metformin, but increased body mass index was observed in monotherapy with oral contraceptives. Administration of metformin or oral contraceptives, especially as monotherapy, had a negative effect on lipid profiles. In addition, there are still uncertainties surrounding the effects of metformin or oral contraceptives in the management of insulin level, although they improved total testosterone and sex hormone-binding globulin levels. In the included studies, significant side effects due to metformin or oral contraceptives were not reported.ConclusionThe clinical trials suggest that metformin or oral contraceptives are at least patient convenient, efficacious, and safe for the treatment of PCOS. However, well-designed, prospective, long-term, large-scale, randomized clinical trials are necessary to elucidate the efficacy and safety of metformin, oral contraceptives, or both in the treatment of PCOS, and to elucidate their individual roles in the treatment of this condition.

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The Effect of Ethinylestradiol (EE)/Cyproterone Acetate (CA) and EE/CA Plus Metformin Treatment on Adhesion Molecules in Cases with Polycystic Ovary Syndrome (PCOS)

Cited by 29 publications

References 31 publications

Soluble platelet/endothelial cell adhesion molecule (sPECAM)-1 is increased in polycystic ovary syndrome and related to endothelial dysfunction

Soluble platelet/endothelial cell adhesion molecule (sPECAM)-1 is increased in polycystic ovary syndrome and related to endothelial dysfunction

Metformin modulates human leukocyte/endothelial cell interactions and proinflammatory cytokines in polycystic ovary syndrome patients

Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome

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