Clinic for Endocrinology, Diabetes and Metabolism Diseases, University Clinical Centre of Sarajevo, Bolnička 25, 71 000 Sarajevo, Bosnia and Herzegovina.
Bosn J Basic Med Sci. 2013 Aug;13(3):180-5. doi: 10.17305/bjbms.2013.2359.
The aim of study was to evaluate endocrine changes in PCOS women during metformin treatment. One hundred women with PCOS, aged 20-40 years were included. A complete hormonal and metabolic pattern was recorded for each subject every 6 months. Metformin treatment after 6 and 12 months significantly reduced weight, BMI, waist circumference, insulin and HOMA-IR (p=0.000) with high differences of variances within repeated measurements. There was significant reduction of PRL, testosterone and estradiol (p=0.000) with small differences within repeated measurements. Metformin did not have effect on TSH. However, results showed important reduction of CRP, LH, LH/FSH, androstendione, DHEA-S and progesterone (p=0.000) with moderate differences within measures. Metformin restored menstrual cyclicity in most participants. At baseline in study group was 69% women with oligomenorrhoea, amenorrhoea or polymenorrhoea. After 12 months of treatment, only 20% PCOS women had irregular menstrual cycle (p=0.000). Hirsutism was also reduced. Intriguingly, during first 6 months of treatment in PCOS women 9 pregnancies occurred (p=0.000), while during last 6 months treatment were 2 pregnancies (p=0.317), in total 11(13%). Multiple regression model revealed that the presence of anovulation in PCOS women was strongly associated with BMI, waist, FSH and age. Insulin resistance was significantly predicted by BMI, cholesterol, progesterone and presence of hirsutism. The metformin therapy significantly improved insulin resistance, imbalance of endocrine hormones, hirsutism and menstrual cyclicity in women with PCOS. The most important predictors for duration of metformin treatment in PCOS women were testosterone, progesterone, FSH, CRP and presence of anovulation.
研究目的在于评估多囊卵巢综合征（PCOS）女性在接受二甲双胍治疗过程中的内分泌变化。本研究纳入了 100 名年龄在 20-40 岁之间的 PCOS 女性。对每位患者每 6 个月记录一次完整的激素和代谢模式。二甲双胍治疗 6 个月和 12 个月后，体重、BMI、腰围、胰岛素和 HOMA-IR 显著降低（p=0.000），重复测量的方差差异较大。PRL、睾酮和雌二醇显著降低（p=0.000），重复测量的方差差异较小。二甲双胍对 TSH 没有影响。然而，结果显示 CRP、LH、LH/FSH、雄烯二酮、DHEA-S 和孕酮显著降低（p=0.000），测量内差异中等。二甲双胍恢复了大多数参与者的月经周期规律性。在研究组中，基线时 69%的女性存在月经稀发、闭经或月经过多。治疗 12 个月后，仅有 20%的 PCOS 女性月经周期不规律（p=0.000）。多毛症也有所减少。有趣的是，在 PCOS 女性接受治疗的前 6 个月，有 9 例妊娠（p=0.000），而在治疗的最后 6 个月，有 2 例妊娠（p=0.317），总计 11 例（13%）。多元回归模型显示，PCOS 女性无排卵的存在与 BMI、腰围、FSH 和年龄密切相关。胰岛素抵抗与 BMI、胆固醇、孕酮和多毛症的存在显著相关。二甲双胍治疗显著改善了 PCOS 女性的胰岛素抵抗、内分泌激素失衡、多毛症和月经周期规律性。PCOS 女性接受二甲双胍治疗的持续时间最重要的预测因子是睾酮、孕酮、FSH、CRP 和无排卵的存在。
