Krysiak Robert, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Exp Clin Endocrinol Diabetes. 2018 Nov;126(10):645-650. doi: 10.1055/a-0584-0006. Epub 2018 Mar 12.
Metformin was found to decrease serum levels of prolactin and thyrotropin. The aim of this study was to investigate the effect of this drug on hypothalamic-pituitary-ovarian axis activity in postmenopausal women with recently diagnosed and untreated glucose metabolism abnormalities.
The study included three matched groups of postmenopausal women: patients with type 2 diabetes (group A, n=16), women with prediabetes (group B, n=14), and individuals with normal glucose metabolism (group C, n=14). Women with diabetes were then treated with high-dose metformin (3 g daily), while women with prediabetes received moderate doses of this agent (1.7 g daily). Glucose homeostasis markers, as well as serum levels of FSH, LH, thyrotropin, prolactin, estradiol and creatinine were measured at baseline and after 16 weeks of metformin treatment.
In both groups of metformin-treated women, the drug improved glucose homeostasis. High-dose metformin treatment reduced circulating levels of FSH and tended to reduce serum levels of LH, and these effects correlated with an improvement in insulin sensitivity. No changes in gonadotropin levels were observed in prediabetic women receiving moderate doses of metformin. Serum levels of thyrotropin, prolactin and estradiol, as well as the estimated glomerular filtration rate remained at a similar level throughout the study.
Our study shows that the effect of metformin on hypothalamic-pituitary-ovarian axis activity in postmenopausal women depends on its dose and the magnitude of insulin resistance.
已发现二甲双胍可降低血清催乳素和促甲状腺激素水平。本研究的目的是调查该药物对近期诊断且未治疗的糖代谢异常的绝经后女性下丘脑 - 垂体 - 卵巢轴活性的影响。
该研究纳入了三组匹配的绝经后女性：2型糖尿病患者（A组，n = 16）、糖尿病前期女性（B组，n = 14）和糖代谢正常个体（C组，n = 14）。糖尿病女性随后接受高剂量二甲双胍治疗（每日3克），而糖尿病前期女性接受中等剂量的该药物治疗（每日1.7克）。在基线和二甲双胍治疗16周后，测量糖稳态标志物以及血清促卵泡生成素（FSH）、促黄体生成素（LH）、促甲状腺激素、催乳素、雌二醇和肌酐水平。
在两组接受二甲双胍治疗的女性中，该药物均改善了糖稳态。高剂量二甲双胍治疗降低了FSH的循环水平，并倾向于降低LH的血清水平，且这些效应与胰岛素敏感性的改善相关。接受中等剂量二甲双胍的糖尿病前期女性的促性腺激素水平未观察到变化。在整个研究过程中，促甲状腺激素、催乳素和雌二醇的血清水平以及估计的肾小球滤过率保持在相似水平。
我们的研究表明，二甲双胍对绝经后女性下丘脑 - 垂体 - 卵巢轴活性的影响取决于其剂量和胰岛素抵抗的程度。
