Javanmanesh Forough, Kashanian Maryam, Rahimi Maryam, Sheikhansari Narges
a Department of Obstetrics & Gynecology , Firoozgar Teaching Hospital, Iran University of Medical Sciences , Tehran , Iran .
b Department of Obstetrics & Gynecology , Akbarabadi Teaching Hospital, Iran University of Medical Sciences , Tehran , Iran , and.
Gynecol Endocrinol. 2016;32(4):285-9. doi: 10.3109/09513590.2015.1115974. Epub 2015 Dec 10.
To compare N-acetyl cysteine (NAC) and metformin on polycystic ovary syndrome (PCOS).
Study was performed as a randomized double-blind clinical trial on women with diagnosis of PCOS without additional complications. In one group, oral NAC 600 mg, three times a day and in the other group, 500 mg oral metformin, three times a day were prescribed. Duration of treatment was 24 weeks, and after finishing this period of treatment, fasting blood glucose (FBS) and insulin, lipid profile and Homeostasis Model Assessment (HOMA) index were measured (all the blood samples were taken while fasting) and were compared in the two groups.
Forty-six women in NAC group and 48 women in metformin group finished the study. The two groups did not show significant difference according to age, body mass index (BMI) of more than 30; mean BMI, AUB, FBS, fasting blood insulin, lipid profile and HOMA index before treatment. After 24 weeks of treatment; BMI >30 [17 (35.4%) versus 7 (15.2%), p = 0.033], mean BMI [(28.36 ± 2.27) versus (27.11 ± 3.55), p = 0.44], number of women with the complain of abnormal uterine bleeding (AUB) [24 (50%) versus 13 (28.3%), p = 0.037], FBS [(90.02 ± 6.24) versus (86.61 ± 7.81), p = 0.021], fasting insulin (10.40 ± 2.64 versus 8.89 ± 2.20, p = 0.004), HOMA Index (2.09 ± 0.69 versus 1.71 ± 0.45, p = 0.001), low density lipoprotein (LDL) (141.83 ± 26.98 versus 127.89 ± 28.70, p = 0.017) were less in NAC group. Triglyceride (TG) and total cholesterol did not show significant difference between the two groups after treatment. High-density lipoprotein (HDL) was higher in NAC group.
NAC can improve lipid profile and fasting blood sugar (FBS) and fasting blood insulin better than metformin.
比较N-乙酰半胱氨酸（NAC）和二甲双胍对多囊卵巢综合征（PCOS）的影响。
本研究为一项随机双盲临床试验，纳入诊断为PCOS且无其他并发症的女性。一组口服NAC 600mg，每日3次；另一组口服二甲双胍500mg，每日3次。治疗持续24周，治疗结束后，测量空腹血糖（FBS）、胰岛素、血脂谱和稳态模型评估（HOMA）指数（所有血样均在空腹时采集），并在两组间进行比较。
NAC组46名女性和二甲双胍组48名女性完成了研究。两组在年龄、体重指数（BMI）大于30、平均BMI、异常子宫出血（AUB）、治疗前FBS、空腹血胰岛素、血脂谱和HOMA指数方面无显著差异。治疗24周后；BMI>30[17（35.4%）对7（15.2%），p=0.033]，平均BMI[（28.36±2.27）对（27.11±3.55），p=0.44]，主诉异常子宫出血（AUB）的女性人数[24（50%）对13（28.3%），p=0.037]，FBS[（90.02±6.24）对（86.61±7.81），p=0.021]，空腹胰岛素（10.40±2.64对8.89±2.20，p=0.004），HOMA指数（2.09±0.69对1.71±0.45，p=0.001），低密度脂蛋白（LDL）（141.83±26.98对127.89±28.70，p=0.017）在NAC组较少。治疗后两组甘油三酯（TG）和总胆固醇无显著差异。NAC组高密度脂蛋白（HDL）较高。
NAC在改善血脂谱、空腹血糖（FBS）和空腹血胰岛素方面比二甲双胍更好。
