Department of Obstetrics and Gynaecology, Aarhus University Hospital, Skejby, Denmark.
Fertil Steril. 2010 Nov;94(6):2234-8. doi: 10.1016/j.fertnstert.2010.01.057. Epub 2010 Mar 2.
To evaluate the effect of metformin in polycystic ovary syndrome (PCOS). As follow-up on a previous paper describing hormonal and metabolic factors, this paper focuses on correlations between adiponectin and anthropometric, hormonal, and metabolic factors in PCOS and the effect of metformin.
Randomized, double-blind, placebo-controlled crossover study.
District and university hospital.
PATIENT(S): Fifty-two women with PCOS. Three groups were defined according to baseline adiponectin.
INTERVENTION(S): Metformin or placebo for 6 months, followed by 3 months' washout before switching to opposite treatment. Blood tests and measurements were performed before and after treatment periods.
MAIN OUTCOME MEASURE(S): Adiponectin, insulin, homeostasis model assessment (HOMA) index, and testosterone.
RESULT(S): Waist-hip ratio (WHR), insulin, and HOMA index were significantly higher in the lower adiponectin group than in the upper and middle group, and high-density lipoprotein (HDL) cholesterol was higher in the upper than in the lower adiponectin group. Multiple regression analysis with adiponectin as the dependent variable and HOMA index, HDL cholesterol, testosterone, and WHR as independent variables showed an R(2) of 0.43 with β-coefficients of -0.12 for the HOMA index, 0.72 for HDL cholesterol, and -1.49 for WHR. Testosterone did not contribute to the prediction of adiponectin levels. Metformin had no effect on adiponectin in spite of significant decreases in weight, fasting glucose, and insulin resistance.
CONCLUSION(S): In PCOS, adiponectin levels are closely linked to insulin resistance, HDL cholesterol, and abdominal adiposity and unaffected by metformin.
评估二甲双胍治疗多囊卵巢综合征（PCOS）的效果。继之前描述激素和代谢因素的论文之后，本文聚焦于 PCOS 患者脂联素与人体测量学、激素和代谢因素的相关性以及二甲双胍的作用。
随机、双盲、安慰剂对照交叉研究。
区医院和大学医院。
52 名 PCOS 患者。根据基线脂联素水平将患者分为三组。
二甲双胍或安慰剂治疗 6 个月，然后洗脱 3 个月，再换用相反的治疗方案。治疗前后进行血液检测和测量。
脂联素、胰岛素、稳态模型评估（HOMA）指数和睾酮。
低脂联素组的腰围-臀围比（WHR）、胰岛素和 HOMA 指数显著高于中脂联素组和高脂联素组，而上脂联素组的高密度脂蛋白（HDL）胆固醇水平高于低脂联素组。以脂联素为因变量，以 HOMA 指数、HDL 胆固醇、睾酮和 WHR 为自变量进行多元回归分析，R(2)为 0.43，HOMA 指数、HDL 胆固醇的β系数分别为-0.12、0.72，WHR 的β系数为-1.49。睾酮对脂联素水平的预测无贡献。尽管体重、空腹血糖和胰岛素抵抗显著下降，二甲双胍对脂联素没有影响。
在 PCOS 中，脂联素水平与胰岛素抵抗、HDL 胆固醇和腹部肥胖密切相关，不受二甲双胍影响。
