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一项关于小檗碱短期疗效的临床研究,与二甲双胍相比,其对多囊卵巢综合征女性代谢特征的影响。

A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome.

机构信息

Department of Gynecology and Obstetrics, Clinical Center of Reproductive Medicine, the First Affiliated Hospital of Harbin Medical University, Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin, Heilongjiang 150001, People's Republic of China.

出版信息

Eur J Endocrinol. 2012 Jan;166(1):99-105. doi: 10.1530/EJE-11-0616. Epub 2011 Oct 21.

Abstract

OBJECTIVE

Polycystic ovary syndrome (PCOS) is a frequent reproductive and metabolic disorder associated with insulin resistance (IR). Berberine (BBR) is an isoquinoline derivative alkaloid extracted from Chinese medicinal herbs that has been used as an insulin sensitizer. BBR may have a potential therapeutic value for PCOS. The aim of this study was to evaluate the effects of BBR in comparison to metformin (MET) on the metabolic features of women with PCOS.

DESIGN AND METHODS

Eighty-nine subjects with PCOS and IR subjects were randomized into one of three treatment groups: BBR+compound cyproterone acetate (CPA; n=31), MET+CPA (n=30), and placebo+CPA (n=28) for 3 months. Clinical characteristics of the women and metabolic and hormonal parameters were assessed before and after the period of treatment.

RESULTS

Treatment with BBR in comparison to MET showed decrease in waist circumference and waist-to-hip ratio (WHR; P<0.01), total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDLC; P<0.05) as well as increase in high-density lipoprotein cholesterol (HDLC) and sex hormone-binding globulin (SHBG; P<0.05). Similarly, treatment with BBR in comparison to placebo showed decrease in WHR, fasting plasma glucose, fasting insulin, homeostasis model assessment for IR, area under the curve of insulin, TC, LDLC, and TG (P<0.05) as well as increase in HDLC and SHBG (P<0.01).

CONCLUSIONS

Intake of BBR improved some of the metabolic and hormonal derangements in a group of treated Chinese women with PCOS. Main effects could be related to the changes in body composition in obesity and dyslipidemia. Further controlled studies are needed for the assessment of the potential favorable metabolic effects of BBR in women with PCOS.

摘要

目的

多囊卵巢综合征(PCOS)是一种与胰岛素抵抗(IR)相关的常见生殖和代谢紊乱。小檗碱(BBR)是一种从中药中提取的异喹啉衍生物生物碱,已被用作胰岛素增敏剂。BBR 可能对 PCOS 具有潜在的治疗价值。本研究旨在评估 BBR 与二甲双胍(MET)相比对 PCOS 患者代谢特征的影响。

设计和方法

将 89 名患有 PCOS 和 IR 的受试者随机分为三组治疗:BBR+复方环丙孕酮(CPA;n=31)、MET+CPA(n=30)和安慰剂+CPA(n=28),治疗 3 个月。在治疗期间前后评估女性的临床特征以及代谢和激素参数。

结果

与 MET 相比,BBR 治疗可降低腰围和腰臀比(WHR;P<0.01)、总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDLC;P<0.05),并增加高密度脂蛋白胆固醇(HDLC)和性激素结合球蛋白(SHBG;P<0.05)。同样,与安慰剂相比,BBR 治疗可降低 WHR、空腹血糖、空腹胰岛素、胰岛素抵抗评估的稳态模型、胰岛素曲线下面积、TC、LDLC 和 TG(P<0.05),并增加 HDLC 和 SHBG(P<0.01)。

结论

BBR 的摄入改善了一组接受治疗的中国 PCOS 女性的一些代谢和激素紊乱。主要作用可能与肥胖和血脂异常时的身体成分变化有关。需要进一步进行对照研究,以评估 BBR 对 PCOS 女性潜在的有利代谢作用。

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