Kilicdag Esra Bulgan, Bagis Tayfun, Tarim Ebru, Aslan Erdogan, Erkanli Serkan, Simsek Erhan, Haydardedeoglu Bulent, Kuscu Esra
Department of Obstetrics and Gynecology, Baskent University Faculty of Medicine, Turkey.
Hum Reprod. 2005 Jun;20(6):1521-8. doi: 10.1093/humrep/deh825. Epub 2005 Mar 24.
The aim of the current study was to assess the effects of B-group vitamins and folic acid administration on serum levels of homocysteine (Hcy) in patients with polycystic ovarian syndrome (PCOS) on short-term metformin treatment.
Patients were randomly assigned to one of three treatment groups. Group 1 patients (n = 20) received metformin (850 mg twice daily); group 2 patients (n = 20) received metformin (850 mg twice daily) and B-group vitamins (vitamin B1, 250 mg; vitamin B6, 250 mg; vitamin B12, 1000 microg twice daily); and group 3 patients (n = 20) received metformin (850 mg twice daily) and folic acid (174 microg twice daily). In all groups, lipid profiles and plasma total Hcy, vitamin B12, folic acid and glucose levels were recorded at baseline and at 3 months.
A 26.5% increase in Hcy levels was seen after 12 weeks of metformin therapy, while 21.17 and 8.33% decreases in Hcy levels were detected when B-group vitamins or folic acid plus metformin were given respectively. There were no statistically significant differences recorded in insulin sensitivity using homeostasis model assessment in the three groups.
These findings suggest that B-group vitamins and folic acid administration counteract the Hcy-increasing effect seen with metformin therapy.
本研究的目的是评估在短期服用二甲双胍治疗的多囊卵巢综合征(PCOS)患者中,给予B族维生素和叶酸对血清同型半胱氨酸(Hcy)水平的影响。
患者被随机分配至三个治疗组之一。第1组患者(n = 20)服用二甲双胍(850毫克,每日两次);第2组患者(n = 20)服用二甲双胍(850毫克,每日两次)和B族维生素(维生素B1,250毫克;维生素B6,250毫克;维生素B12,1000微克,每日两次);第3组患者(n = 20)服用二甲双胍(850毫克,每日两次)和叶酸(174微克,每日两次)。在所有组中,于基线及3个月时记录血脂谱、血浆总Hcy、维生素B12、叶酸和葡萄糖水平。
二甲双胍治疗12周后,Hcy水平升高了26.5%,而分别给予B族维生素或叶酸加二甲双胍时,Hcy水平下降了21.17%和8.33%。三组使用稳态模型评估胰岛素敏感性时,未记录到统计学上的显著差异。
这些发现表明,给予B族维生素和叶酸可抵消二甲双胍治疗所产生的Hcy升高效应。