Endocrine Department, Elena Venizelou Hospital, Athens GR-115 21, Greece.
Gynecol Endocrinol. 2009 Jul;25(7):427-34. doi: 10.1080/09513590902770172.
AIM. To elucidate the dynamics of FSH, LH, prolactin (PRL), TSH and insulin secretion in women with polycystic ovarian syndrome (PCOS) treated with metformin (MET).
In a prospective, controlled and randomised trial, 32 women with PCOS and 32 with normal cycle were recruited to receive MET (850 mg b.i.d.) or placebo (n: 16 for each subgroup) for an average of 40 days. Pituitary function and insulin secretion were assessed before and after intervention by GnRH-TRH tests and oral glucose tolerance test induced insulin response.
Basal and area under the response curve (AURC) LH values were higher in PCOS than in normal controls before MET and declined following treatment in the former group (P < 0.05). Ovulatory PCOS responders had lower basal LH, AURC(LH) and AURC(PRL) values during MET than anovulatory cases (P < 0.05 for all) and AURCins was lower in ovulatory than anovulatory PCOS before and on MET (P < 0.02-P < 0.05), with a rise of QUICKY index in the former group during MET treatment (P < 0.05). FSH and TSH were similar.
MET administration lowered LH activity in all PCOS women and in ovulatory responders and also compromised PRL stimulated secretion in the latter cases. These findings were indicative of an effect of MET on pituitary activity.
阐明多囊卵巢综合征(PCOS)患者接受二甲双胍(MET)治疗后,卵泡刺激素(FSH)、黄体生成素(LH)、催乳素(PRL)、促甲状腺激素(TSH)和胰岛素分泌的动力学变化。
在一项前瞻性、对照和随机试验中,招募了 32 名 PCOS 患者和 32 名正常周期患者,分别接受 MET(850mg,每日两次)或安慰剂(每组 16 名)治疗,平均 40 天。在干预前后,通过 GnRH-TRH 试验和口服葡萄糖耐量试验诱导的胰岛素反应评估垂体功能和胰岛素分泌。
在接受 MET 治疗之前,PCOS 患者的基础和反应曲线下面积(AURC)LH 值高于正常对照组,并且在治疗后前者的 LH 值下降(P<0.05)。有排卵的 PCOS 患者在 MET 治疗期间的基础 LH、AURC(LH)和 AURC(PRL)值低于无排卵病例(所有 P 值均<0.05),并且在 MET 治疗前后,有排卵的 PCOS 患者的 AURCins 值低于无排卵病例(P<0.02-P<0.05),并且在 MET 治疗期间,前者的 QUICKY 指数升高(P<0.05)。FSH 和 TSH 相似。
MET 治疗降低了所有 PCOS 患者和排卵反应者的 LH 活性,并在后者病例中也损害了 PRL 刺激的分泌。这些发现表明 MET 对垂体活性有影响。