The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome

Yang, Pei‐Chi; Hsu, Chih Yuan; Chen, Mei-Jou; Lai, Mei Yu; Li, Zheng Rong; Chen, Chen Hsin; Chen, Shee‐Uan; Ho, Hong Nerng

doi:10.1210/jc.2017-01739

Cited by 40 publications

(30 citation statements)

References 38 publications

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“…Another point of concern is the high rate of dropouts and the effects that may have on the study outcome. However, this attrition rate was similar to that from other studies on PCOS (16,30).…”

Section: Limitations and Strengthssupporting

confidence: 88%

“…Increased menstrual frequency correlated with the decrease in BM and total testosterone, whereas no correlation with the change in LH/FSH ratio was demonstrated. Weight, insulin resistance, testosterone and LH/FSH disturbances are established determinants of menstrual regularity (31); yet, the relative contributions of those parameters 9:1 on menstrual regularity across the different phenotypes of PCOS and the consequences of metformin impact on these different spectrums are currently unknown (30). As menstrual irregularity in PCOS typically improves with time, we also stratified patients by age and confirmed the increase in patients younger than 35 years and in patients ≥35 years old at baseline.…”

Section: Impact On Menstrual Regularitysupporting

confidence: 54%

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Long-term efficacy of metformin in overweight-obese PCOS: longitudinal follow-up of retrospective cohort

Jensterle

Kravos

Ferjan

et al. 2020

Endocrine Connections

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Objective Long-term efficacy of metformin in polycystic ovarian syndrome (PCOS) apart from in those with impaired glucose tolerance or diabetes remains unproven. We aimed to evaluate the impact of metformin in overweight-obese patients with PCOS and normal baseline glycemic homeostasis. Methods A 10-year longitudinal follow-up of a retrospective cohort comprising 159 patients with PCOS defined by Rotterdam criteria, BMI ≥25 kg/m2 and normal initial glucose homeostasis (age 28.4 ± 6.4 years, BMI 34.9 ± 6.6 kg/m2) that had been receiving metformin 1000 mg BID. Collection data contained 6085 time-points including anthropometric, hormonal and metabolic parameters. Results After the first year body mass (BM) decreased for 3.9 ± 6.8 kg (P < 0.001) and remained stable during the following 3 years. Menstrual frequency (MF) increased to 3.0 ± 3.9 bleeds/year (P < 0.001) after first year to over 11 bleeds/year in the following years. The total testosterone and androstenedione decreased to 15.4 ± 47.9% and 11.3 ± 46.4% within first year, with further decrease in total testosterone and androstenedione to 37.8 ± 61.8 and 24.8 ± 40.5% at the fifth year of the follow-up. The total conversion rate to prediabetes and diabetes was extremely low throughout observation period. Less than 25% of patients continued with metformin for more than 5 years with further dropout to only 6% on metformin therapy at the tenth year of follow-up. Conclusions Long-term metformin treatment of overweight-obese women with PCOS and normal baseline glycemic homeostasis resulted in reduction and stabilization of BM, improvements of MF and androgen profile and low conversion rate to diabetes.

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Section: Limitations and Strengthssupporting

confidence: 88%

Section: Impact On Menstrual Regularitysupporting

confidence: 54%

Long-term efficacy of metformin in overweight-obese PCOS: longitudinal follow-up of retrospective cohort

Jensterle

Kravos

Ferjan

et al. 2020

Endocrine Connections

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“…58 This mechanism may lead to the favorable effect metformin has on BMI, [59][60][61] menstrual frequency, 59,62 systolic blood pressure, 61,62 fasting glucose levels, 62 fasting insulin levels, 62 testosterone, 59,61,62 triglyceride levels, 61 and LH levels. 59 Results, however, do show high levels of heterogeneity. An effect has not been reported on mFG scores, 61 cholesterol levels, 61,62 or free androgen index.…”

Section: Treatment Of Nonreproductive Outcomesmentioning

confidence: 99%

A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines

et al. 2018

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Polycystic ovary syndrome (PCOS) is a common hormonal condition with reproductive, metabolic, and psychological sequelae. The Rotterdam Criteria are now internationally accepted, with different phenotypes recognized with varying clinical presentations and risk profiles. The complexity of the disorder, and the impact on quality of life, requires timely diagnosis, screening for complications and management strategies. PCOS remains underdiagnosed and women experience significant delays to diagnosis. Effective dissemination of evidence-based management is therefore vital. In this review, we summarize key aspects of PCOS as a prelude to this issue of on PCOS which focuses on the development of the international evidence-based guideline on the assessment and management of PCOS and the related translation program. We cover diagnostic criteria, prevalence, phenotypes, reproductive, metabolic, and psychological factors of PCOS. We also cover management strategies including lifestyle interventions as well as treatment of nonreproductive outcomes and reproductive outcomes informed by the latest international evidence-based guidelines.

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“…Metformin (Loditon, Standard Chem and Pharm, Taiwan) was started at 500 mg/day in the first month, 1000 mg/day in the second month, 1500 mg/day in the third month, and continued at 1500 mg/day for one year, as described previously [17]. A decrease to 1000 mg daily dose was allowed for patients who reported gastrointestinal symptoms, such as abdominal distention and cramping, that affected daily activities.…”

Section: Protocol and Data Collectionmentioning

confidence: 99%

Changes in peripheral mitochondrial DNA copy number in metformin-treated women with polycystic ovary syndrome: a longitudinal study

Yang

Chou

Chang

et al. 2020

Reprod Biol Endocrinol

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Background: Patients with polycystic ovarian syndrome (PCOS) are associated with known alterations in mitochondria DNA copy number (mtDNA-CN). The aim of this study is to study the change in mtDNA-CN in patients with PCOS who were treated with metformin. Methods: This is a prospective cohort of patients with PCOS, who received metformin for one year. From 2009 to 2015, 88 women diagnosed with PCOS, based on the Rotterdam criteria, were enrolled. Serial measurements of mtDNA-CN, 8-hydroxydeoxyguanosine (8-OHdG), anthropometric, metabolic, endocrine, and inflammatory markers were obtained before and after 3, 6, and 12 months of treatment. Results: A significant decrease in mtDNA-CN was seen over the course of one year. Other markers, including 8-OHdG, testosterone, free androgen index, blood pressure and liver enzymes, also decreased in the same interval. On regression analysis, there was a significant association between the change in mtDNA-CN and serum total testosterone, and no association between mtDNA-CN and metabolic factors. Conclusions: Treatment with metformin is associated with a time-dependent decrease in mtDNA-CN in patients with PCOS who are treated over the course of one year. This may signify a reduction in mitochondria dysfunction. The change in mtDNA-CN corresponds to a similar change in serum total testosterone, and suggests a possible relationship between mtDNA-CN and testosterone.

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The Efficacy of 24-Month Metformin for Improving Menses, Hormones, and Metabolic Profiles in Polycystic Ovary Syndrome

Cited by 40 publications

References 38 publications

Long-term efficacy of metformin in overweight-obese PCOS: longitudinal follow-up of retrospective cohort

Long-term efficacy of metformin in overweight-obese PCOS: longitudinal follow-up of retrospective cohort

A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines

Changes in peripheral mitochondrial DNA copy number in metformin-treated women with polycystic ovary syndrome: a longitudinal study

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