The effects of metformin on metabolic and cardiovascular risk factors in nonobese women with polycystic ovary syndrome

Şahin, Yılmaz; Ünlühızarcı, Kürşad; Yilmazsoy, Ayse; Yıkılmaz, Ali; Aygen, Ercan; Keleştimur, Fahrettin

doi:10.1111/j.1365-2265.2007.02985.x

Cited by 58 publications

(54 citation statements)

References 39 publications

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“…The increase of serum Hcy concentration in the metformin-treated patients was confirmed by a series of observational studies [16][17][18]20,25,[52][53][54][55][56]. These studies indicated that metformin was associated with an elevated concentration of serum Hcy compared with control treatment.…”

Section: Discussionmentioning

confidence: 52%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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Abstract:The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine (Hcy) with and without simultaneous supplementation of B-group vitamins or folic acid. A literature search was conducted in PubMed, EmBase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials (RCTs) reporting the concentration of serum Hcy in metformin-treated adults. Meta-analysis was applied to assess the association between metformin and the changes of Hcy concentration. Twelve publications were included in this study. In the overall analysis, metformin administration was not statistically associated with the change of Hcy when compared with the control treatment (mean difference (MD), 0.40 µmol/L; 95% confidence interval (CI), −0.07~0.87 µmol/L, p = 0.10). In the subgroup analysis, metformin was significantly associated with an increased concentration of Hcy in the absence of exogenous supplementation of folic acid or B-group vitamins (MD, 2.02 µmol/L; 95% CI, 1.37~2.67 µmol/L, p < 0.00001), but with a decreased concentration of serum Hcy in the presence of these exogenous supplementations (MD, −0.74 µmol/L; 95% CI, −1.19~−0.30 µmol/L, p = 0.001). Therefore, although the overall effect of metformin on the concentration of serum Hcy was neutral, our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given.

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Section: Discussionmentioning

confidence: 52%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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“…In our cohort of PCOS subjects, levels of 17␤-estradiol, testosterone, androstenedione, and DHEA-S were significantly higher than in the control subjects. We, like others (18,19), observed a significant decrease in levels of 17␤-estradiol and testosterone, with no significant difference in androstenedione and DHEA-S levels, in response to metformin treatment. Could it be that a decrease in gonadal steroid levels causes a decrease in vaspin levels?…”

Section: Discussionmentioning

confidence: 80%

Metformin Decreases the Adipokine Vaspin in Overweight Women With Polycystic Ovary Syndrome Concomitant With Improvement in Insulin Sensitivity and a Decrease in Insulin Resistance

et al. 2008

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OBJECTIVE-Polycystic ovary syndrome (PCOS) is associated with insulin resistance and obesity. Vaspin (visceral adipose tissue-derived serine protease inhibitor) levels increase with hyperinsulinemia and obesity. Currently, no data exists on vaspin in PCOS women. We therefore assessed mRNA and protein levels of vaspin, including circulating vaspin, from subcutaneous and omental adipose tissue of PCOS women and matched control subjects. Ex vivo regulation of adipose tissue vaspin and the effects of metformin treatment on circulating vaspin levels in PCOS subjects were also studied. RESEARCH DESIGN AND METHODS-Real-time RT-PCRand Western blotting were used to assess mRNA and protein expression of vaspin. Serum vaspin was quantified by enzymelinked immunosorbent assay. The effects of D-glucose, insulin, and gonadal and adrenal steroids on adipose tissue vaspin were analyzed ex vivo.RESULTS-There were significantly higher levels of circulating vaspin (P Ͻ 0.05), vaspin mRNA (P Ͻ 0.05), and protein (P Ͻ 0.05) in omental adipose tissue of PCOS women. Interestingly, in omental adipose tissue explants, glucose significantly increased vaspin protein levels and secretion into conditioned media (P Ͻ 0.001). Also, after 6 months of metformin treatment, there was a significant decrease in serum vaspin levels in PCOS women (P Ͻ 0.001). Furthermore, multivariate regression analysis revealed that following metformin therapy, changes in circulating glucose levels were predictive of changes in serum vaspin levels (P ϭ 0.014).CONCLUSIONS-We report, for the first time, elevated serum and omental adipose tissue levels of vaspin in overweight PCOS women and ex vivo regulation of vaspin, predominantly by glucose. More importantly, metformin treatment decreases serum vaspin levels, a novel observation. Diabetes 57:1501-1507, 2008

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“…In addition, Cibula (13) reported that a considerable portion of women with PCOS have insulin sensitivity comparable with healthy controls. According to previous reports, thin female patients with PCOS do not respond to metformin and show no metabolic improvement after treatment of metformin (14,15). These observations suggested that other mechanisms, rather insulin resistance, might be involved in PCOS development.…”

Section: Discussionmentioning

confidence: 92%

“…Estradiol (E2) was 45.94 pg/mL (<20-145), progesterone was 0.58 ng/mL (<1.0), prolactin was 16.24 ng/mL (0-20), and 17α-OHprogesterone was 1.11 ng/mL (0.2-1) at the 3rd day of the follicular phase. The LH/FSH ratio was 3.1 (LH 22.02 mIU/ mL (2-15), and FSH was 7.04 mIU/mL (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Progesterone withdrawal test was positive, and the polycystic ovary was confirmed by uterine ultrasonography (Fig.…”

Section: Introductionmentioning

confidence: 98%

A 27-Year-Old Woman Diagnosed as Polycystic Ovary Syndrome Associated with Graves' Disease

et al. 2011

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Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m 2 ), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously.

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The effects of metformin on metabolic and cardiovascular risk factors in nonobese women with polycystic ovary syndrome

Abstract: Metformin may have beneficial effects in lean PCOS women in terms of resumption of menses without any remarkable effect on metabolic and cardiovascular risk factors.

Cited by 58 publications

References 39 publications

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Metformin Decreases the Adipokine Vaspin in Overweight Women With Polycystic Ovary Syndrome Concomitant With Improvement in Insulin Sensitivity and a Decrease in Insulin Resistance

A 27-Year-Old Woman Diagnosed as Polycystic Ovary Syndrome Associated with Graves' Disease

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