Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Clin Endocrinol (Oxf). 2013 Aug;79(2):199-203. doi: 10.1111/cen.12028. Epub 2013 Apr 1.
Hyperinsulinaemia is an important determinant of the polycystic ovarian syndrome (PCOS). In addition to lifestyle measures, therapeutic strategies include the use of oestrogen-progesterone combination pills (EP), and insulin sensitizers such as metformin, either alone or in combination. Data are limited regarding the impact of metformin alone vs metformin with EP on cardiometabolic risk in overweight adolescents with PCOS. We hypothesized that metformin alone would lead to an improvement in HbA1C and lipid levels in overweight adolescent girls with PCOS compared with meformin with EP.
Retrospective clinic-based therapy.
We examined the effects of therapy with metformin alone (n = 14) vs metformin with EP (n = 13) on HbA1C and lipid parameters over 10-14 months in 27 overweight girls, drawn from a clinic population of adolescents with PCOS.
The groups did not differ for age, body mass index (BMI), HbA1C or baseline lipids. After at least 10 months, the metformin only group compared with the metformin and EP group had a decrease in total cholesterol (-0·605 ± 0·100 vs 0·170 ± 0·348 mm, P = 0·02, nonparametric test) and triglycerides (-0·342 ± 0·184 vs 0·262 ± 0·133 mm, P = 0·02), despite similar changes in BMI (-1·6 ± 0·7 vs 0·6 ± 2·1 kg/m(2) , P = 0·25) and HbA1C (0·03 ± 0·06 vs 0·03 ± 0·13%, P = 0·99). Differences between groups remained significant after controlling for baseline parameters and for changes in BMI.
Metformin alone more effectively improves lipid parameters than metformin with EP in adolescent PCOS, as indicated by a decrease in total cholesterol and triglycerides. This effect is not related to BMI changes.
高胰岛素血症是多囊卵巢综合征（PCOS）的一个重要决定因素。除了生活方式措施外，治疗策略还包括使用雌激素-孕激素联合丸（EP），以及单独或联合使用胰岛素增敏剂，如二甲双胍。关于二甲双胍单独使用与 EP 联合使用对超重青少年 PCOS 的心脏代谢风险的影响的数据有限。我们假设，与 EP 联合使用二甲双胍相比，二甲双胍单独使用可改善超重青少年 PCOS 患者的 HbA1C 和血脂水平。
回顾性基于诊所的治疗。
我们检查了在 27 名超重女孩中，单独使用二甲双胍（n = 14）与 EP 联合使用二甲双胍（n = 13）治疗 10-14 个月对 HbA1C 和血脂参数的影响，这些女孩来自于青少年 PCOS 诊所人群。
两组在年龄、体重指数（BMI）、HbA1C 或基线血脂方面无差异。至少 10 个月后，与 EP 联合使用二甲双胍组相比，仅使用二甲双胍组的总胆固醇（-0.605 ± 0.100 与 0.170 ± 0.348 mm，P = 0.02，非参数检验）和甘油三酯（-0.342 ± 0.184 与 0.262 ± 0.133 mm，P = 0.02）降低，尽管 BMI 变化相似（-1.6 ± 0.7 与 0.6 ± 2.1 kg/m2，P = 0.25）和 HbA1C（0.03 ± 0.06 与 0.03 ± 0.13%，P = 0.99）。在控制基线参数和 BMI 变化后，组间差异仍然显著。
与 EP 联合使用二甲双胍相比，二甲双胍单独使用更有效地改善青少年 PCOS 的血脂参数，表现为总胆固醇和甘油三酯降低。这种作用与 BMI 变化无关。
