Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt,
Arch Gynecol Obstet. 2014 Apr;289(4):883-91. doi: 10.1007/s00404-013-3057-8. Epub 2013 Nov 7.
To authenticate the effect of metformin treatment on ovarian stromal blood flow in women with polycystic ovary syndrome (PCOS) using 3-dimensional (3D) power Doppler.
The current case-control study was conducted at Ain Shams University Maternity Hospital. A total of 60 women diagnosed to have PCOS were included as group 1. Another 40 fertile women who were recruited from outpatient clinic for contraception without PCOS with regular menstrual cycles were included as control group (group 2). All women underwent 3D power Doppler evaluations of ovarian stroma. Anthropometric, hormonal and biochemical criteria were also measured. All women in group 1 received metformin hydrochloride 500 mg tablets, which were started in a step-up maneuver every 5 days, from one to three tablets per day. The same parameters were also measured after the 3 months duration of treatment.
A total of 100 women were finally analyzed. At the start of the study, there were no statistically significant differences between group 1 and group 2 and regarding age and body mass index, but the waist/hip ratio and Ferriman-Gallwey scoring were statistically different between the 2 groups. The mean ovarian volume and stromal volume were significantly larger in group 1. 3D power Doppler indices [the vascularization index (VI), the flow index (FI) and the (VFI) vascularization-flow index] were much higher in group 1 than in group 2 (1.38 ± 0.76 vs. 4.69 ± 1.37, P < 0.05, 26.59 ± 2.26 vs. 32.66 ± 4.37, P < 0.05, and 0.76 ± 0.39 vs. 1.54 ± 0.69, P < 0.05, respectively). After 3 months of using metformin in normal weight PCO women, there was a statistically significant improvement in group 1 regarding, hirsutism, most of hormonal measurements. Also 3 months metformin treatment significantly reduce VI, FI and VFI (4.69 ± 1.37 vs. 2.95 ± 1.52, P < 0.05, 32.66 ± 4.37 vs. 29.48 ± 4.98, P < 0.05 and 1.54 ± 0.69 vs. 1.21 ± 0.7 P < 0.05, respectively). Using Receiver operator characteristic, there was no cut-off value of VI, FI or VFI to detect ovulation in women of PCOS.
Metformin seems to have a beneficial effect in normal weight PCO women via correcting ovarian stromal blood flow and hormonal profiles.
使用三维（3D）能量多普勒来验证二甲双胍治疗多囊卵巢综合征（PCOS）患者卵巢间质血流的效果。
本病例对照研究在艾因夏姆斯大学妇产医院进行。共有 60 名被诊断为 PCOS 的女性被纳入第 1 组（组 1）。另外，40 名来自门诊避孕且无 PCOS 的生育期女性，月经周期规律，被纳入对照组（组 2）。所有女性均接受卵巢间质的 3D 能量多普勒评估。还测量了人体测量、激素和生化标准。组 1 中的所有女性均接受盐酸二甲双胍 500mg 片剂治疗，以逐步递增的方式开始服药，每隔 5 天服用 1 至 3 片。治疗 3 个月后，也测量了相同的参数。
最终分析了 100 名女性。在研究开始时，组 1 和组 2 之间在年龄和体重指数方面没有统计学差异，但两组之间的腰围/臀围比和 Ferriman-Gallwey 评分存在统计学差异。组 1 的卵巢体积和间质体积明显较大。组 1 的 3D 能量多普勒指数[血管化指数（VI）、血流指数（FI）和血管化-血流指数（VFI）]明显高于组 2（1.38±0.76 比 4.69±1.37，P<0.05，26.59±2.26 比 32.66±4.37，P<0.05，和 0.76±0.39 比 1.54±0.69，P<0.05）。在正常体重 PCO 女性中使用二甲双胍 3 个月后，组 1 的多毛症、大多数激素测量值均有统计学显著改善。此外，3 个月的二甲双胍治疗可显著降低 VI、FI 和 VFI（4.69±1.37 比 2.95±1.52，P<0.05，32.66±4.37 比 29.48±4.98，P<0.05，和 1.54±0.69 比 1.21±0.7 P<0.05）。使用接收者操作特征曲线，没有 VI、FI 或 VFI 的截断值可以检测 PCOS 女性的排卵。
二甲双胍似乎通过纠正卵巢间质血流和激素谱对正常体重 PCO 女性有有益的影响。
