Mitkov M, Pehlivanov B, Terzieva D
Department of Endocrinology, Medical University, Plovdiv, Bulgaria.
Eur J Obstet Gynecol Reprod Biol. 2006 May 1;126(1):93-8. doi: 10.1016/j.ejogrb.2005.11.019. Epub 2005 Dec 19.
The aim of our study is to investigate and compare the clinical, biochemical and hormonal changes during application of insulin-sensitizers from two different groups.
This prospective, open clinical study lasted 3 months and included 30 women with PCOS, divided in two groups of 15 women each. Group 1 received 850 mg metformin twice a day and group 2 was treated with rosiglitazone 4 mg a day. Serum levels of testosterone, immune reactive insulin (IRI), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS) and lipid metabolism parameters were measured before the treatment, and on the 3rd month. Free androgen index (FAI) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed at baseline and at the end of therapy.
Two parameters change significantly in the 3rd month in our study--testosterone and insulin. Much better decrease in the level of testosterone and free androgen index was established in group treated with metformin, while the indices of insulin resistance were better influenced in the group treated with rosiglitazone.
Application of insulin sensitizers from both groups has a favorable influence on the basic hormonal deviations in PCOS--the hyperandrogenemia and the insulin resistance. In cases with PCOS metformin treatment influences better hyperandrogenemia, while rosiglitazone affects more pronouncedly insulin resistance and hyperinsulinemia.
本研究旨在调查和比较来自两个不同组的胰岛素增敏剂应用过程中的临床、生化和激素变化。
这项前瞻性、开放性临床研究持续了3个月，纳入了30名多囊卵巢综合征（PCOS）女性，分为两组，每组15名女性。第1组每天两次服用850毫克二甲双胍，第2组每天服用4毫克罗格列酮进行治疗。在治疗前及治疗第3个月时测量血清睾酮、免疫反应性胰岛素（IRI）、性激素结合球蛋白（SHBG）、硫酸脱氢表雄酮（DHEAS）水平以及脂质代谢参数。计算游离雄激素指数（FAI）和胰岛素抵抗稳态模型评估（HOMA-IR）。在基线和治疗结束时评估体重指数（BMI）和腰臀比（WHR）。
在我们的研究中，第3个月有两个参数发生了显著变化——睾酮和胰岛素。二甲双胍治疗组的睾酮水平和游离雄激素指数下降得更好，而罗格列酮治疗组的胰岛素抵抗指标受到的影响更好。
两组胰岛素增敏剂的应用对PCOS的基本激素异常——高雄激素血症和胰岛素抵抗都有有利影响。在PCOS病例中，二甲双胍治疗对高雄激素血症的影响更好，而罗格列酮对胰岛素抵抗和高胰岛素血症的影响更明显。
